Back Pain and chiropractic

Even though chiropractic care works wonders for some people, others are not convinced that it can be an effective treatment.

• Chiropractic: What is chiropractic manipulation?

But research has shown that while chiropractic care hasn’t helped issues like asthma, it can be a huge help for painTrusted Source, especially in the lower back.

A recent studyTrusted Source in JAMA Network Open focused on U.S. military personnel. It found that those who used chiropractic care — along with traditional medical care — had better pain relief outcomes than those who only sought out traditional medical care.

It’s a key finding for this group since low back pain is one of the leading causes of disabilityTrusted Source among U.S. military personnel.

Chiropractic care can include different forms of spinal manipulation commonly known as adjustments. Not all chiropractic care involves cracking bones directly. One technique uses a handheld device called an activator, a gentler way to align your spine. Another involves moving the table to align the patient’s body.

This care is different than the typical medical remedies for back pain which include anti-inflammatory medications, opioids, spinal fusions, and epidural steroid injections.

But with the ongoing opioid crisis in the United States, the medical community is looking at alternative nonaddictive treatments.

What did the study researchers find out?

Between 2012 and 2016, a research team evaluated chiropractic care on 750 active-duty U.S. military service members. The mean age of participants was 30.9 years old.

The patients were put into two groups. One group received traditional medical care for back pain along with chiropractic care; the other group only received traditional care. While traditional care can include medication, the chiropractic care included spinal manipulation adjustments along with manual therapies such as ice, heat, cryotherapy, and rehabilitative exercises.

After six weeks, those who got both types of care reported moderately higher improvements in pain intensity and disability compared with those who only received traditional medical care.

“The current study provides the strongest evidence to date that chiropractic care is safe, effective, and results in high levels of patient satisfaction and perceived treatment benefit, thus strengthening our knowledge regarding this conservative nondrug option for low back pain,” Christine M. Goertz, DC, PhD, a chiropractor with the Spine Institute for Quality in Iowa, told Healthline.

In an accompanying editorialTrusted Source, Daniel C. Cherkin, PhD, a senior investigator at Kaiser Permanente Washington Health Research Institute, said the study will help medical experts better treat military personnel.

“This trial represents an important contribution to our minimal knowledge of the potential of chiropractic care to improve outcomes of care in military populations,” he wrote.

But, Cherkin said integrating chiropractic care into the military health system will require communication and referrals.

Doing so has the “potential for more effectively and efficiently serving patients,” he explained.

A successful military model could also help civilians get more access to chiropractic care as well.

Can chiropractic care catch on?

Back or neck pain is common among adults in the United States — not just those in the military — and both patients and physicians are looking for better ways to treat pain.

Recent Gallup studies found that about 1 in 4 adults saw a medical professional for neck or back pain in the last year and 65 percent sought care at some point during their lives.

The American College of Physicians, the U.S. Food and Drug Administration, and the Joint Commission all recommend nondrug therapies for back pain as an initial treatment approach, Goertz said.

“Yet, I am hearing… that the use of these therapies, including chiropractic care, has not increased since these guidelines were issued,” she added.

But research shows that patients are becoming wary of pills as a single solution. At least 78 percent of American adults would like to try ways other than medication to relieve their pain, according to Gallup.

A 2016Trusted Source study Goertz contributed to showed that about 14 percent of people have seen a chiropractor in the last year. Of those with significant neck or back pain, 33 percent said chiropractic care was safest compared with 12 percent who say pain medications are safer (physical therapy was perceived as safest), according to Gallup data. Also, 29 percent say chiropractic care is more effective than pain medication for those who have neck or back pain, while 22 percent preferred medication over chiropractic care.

The Gallup data found that 53 percent of U.S. adults say they would most like to see a medical doctor about their neck or back pain, while 28 percent would prefer to see a chiropractor.

So why are some Americans still popping pills when a chiropractic adjustment may be just as, or even more, effective?

Goertz said patient preferences and evidence-based guidelines for low back pain are disconnected from what’s happening in our healthcare systems. People may turn to medication as part of a regular habit, though financial incentives could come into play.

Some health plans only consider chiropractic care after traditional treatments have failed instead of making it a first-line treatment option, Goertz explained.

What to expect at the chiropractor

Peter Ottone, DC, a chiropractor from New Jersey, said that many people are simply afraid of chiropractic care — until they’ve tried it. Once people become chiropractic patients, they usually call their chiropractor first for pain relief.

“Patients who have already used chiropractic as part of their healthcare program will generally call their chiropractor first,” Ottone said.

He pointed out that people who have never visited a chiropractor may be apprehensive and fearful.

“I regularly have first-time chiropractic patients present to my office and tell me how scared they are to get adjusted,” he said. “Once it’s explained how chiropractic works and the types of treatments rendered are presented to them, I find most patients are much more at ease and comfortable with their choice to try chiropractic.”