Spinal manipulation may help in short term

DEAR DOCTOR K: I suffer from low back pain, and I’m thinking of visiting a chiropractor for spinal manipulation treatments. What do you think?

DEAR READER: Spinal manipulation treatments are performed by chiropractors, osteopaths, and some massage and physical therapists. More than one of my patients has tried this treatment for back pain. They usually don’t like to tell me about it because they think I’ll disapprove.

Actually, I think there is evidence from scientific studies that chiropractic therapy for short-term or recurrent pain may be at least as effective as the treatments that I have to offer. But there’s not enough evidence to recommend chiropractic care for chronic back pain.

When treating people with low back pain, chiropractors and the other health workers may also use other therapies. These include massage, heat and cold therapies, and electrotherapies. For some people, chiropractic care reduces the amount of medication needed to control pain.

A 2010 review looked at 12 studies involving 2,887 people with low back pain. It concluded that chiropractic care improved short- and medium-term pain more than other treatments. These included exercise, physical therapy and medication. But the overall differences were slight – and there was no difference in long-term pain. People who saw chiropractors also reported less short-term disability compared with people who received other treatments. But again, the difference was small.

On the other hand, studies like this one give us good information about the experience of the average patient. You may or may not be like the “average” patient. If you have had good relief from spinal manipulation in the past, I would not discourage you from trying it again.

If you do try spinal manipulation, seek out an experienced practitioner. Until there is more evidence, a short-term approach is best.