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One of the most effective ways by which lower back pain can be treated is through chiropractic care. Chiropractic care uses manipulation of the spine and other manual methods. These chiropractic methods are based on the fact that the body's musculoskeletal system will eventually heal itself through proper alignment even without surgery or medications. Chiropractic care makes use of manipulation, which restores the movements of the joints by making the body heal from joint tissue injury brought about by trauma such as repetitive stress, falls, and postural defects.Chiropractic care is often used by many people to relieve pain in the joints, muscles, bones and connective tissues. It may or may be combined with medical or surgical care. Chiropractic care is usually done by a licensed chiropractor, who has undergone an undergraduate degree plus four years of chiropractic education. Chiropractors usually attach the initials D.C. after their names.
So how does a chiropractor treat lower back pain? First a complete medical history is obtained, after which a through physical examination is done. The chiropractor may then request additional lab tests to prove his or her diagnosis.
Next the chiropractor will then explain to you his or her plan of treatment. Treatment may often involve one or more manual adjustments. In this process, the chiropractic doctor manipulations the joints using a sudden yet controlled force so that the joints will be able to restore their range of motion with less discomfort and limitation. This manipulation of the joint—also termed as adjustment—is able to move the joint beyond its usual range of motion. Some people being treated with spinal adjustment could hear a cracking or popping sound during the procedure. Don't worry, that's perfectly normal! This is being done so that the body will be able to restore its full physical function. In this way, pain is relieved and strength and stamina is restored.
The question now is this: is chiropractic care really effective in treating lower back pain? There are quite a number of studies which have proved that chiropractic care could effectively treat low back pain.
A Cochrane review done by Walker et al determined the effects of combined chiropractic interventions on pain, disability, back-related function, overall improvement, and patient satisfaction in adults with lower back pain (LBP). This review examined 12 studies utilizing 2887 subjects with lower back pain. Their study revealed that combined chiropractic interventions slightly improved pain and disability in the short term and pain in the medium term for acute or sub-acute lower back pain.
Another study by McMorland et al compared the clinical efficacy of spinal manipulation against microdiskectomy in patients with sciatica secondary to lumbar disk herniation (LDH). This study utilized 40 subjects who were screened for symptoms of unilateral lumbar radiculopathy secondary to LDH at L3-4, L4-5, or L5-S1. These subjects were then randomized to either surgical microdiskectomy or standardized chiropractic spinal manipulation for 3 months. Sixty percent of patients with sciatica who had failed other medical management benefited from spinal manipulation to the same degree as if they underwent surgical intervention. The study suggested that patients with symptomatic LDH failing medical management should consider spinal manipulation followed by surgery only if necessary.
In a study by Hoisiis et al, chiropractic adjustments were compared to muscle relaxants for sub-acute low back pain. Their findings revealed that chiropractic care was more beneficial than placebo in reducing pain and more beneficial than either placebo or muscle relaxants in reducing pain.
Chiropractic care was also proven to be effective in reducing pregnancy-associated lower back pain, according to a study by Stuber et al. This study systematically reviewed published evidence regarding chiropractic care, including spinal manipulation, for pregnancy-related lower back pain (LBP). Results from 6 studies showed that chiropractic care is associated with improved outcomes in pregnancy-related LBP.
Chiropractic care was also studied to be effective against osteoarthritis-related lower back. According to Beyerman et al , chiropractic care combined with heat is more effective than heat alone for treating osteoarthritis-based lower back pain. Pain reduction occurs more rapidly and to a greater degree, and ROM increases more rapidly and to a greater degree.
Chiropractic care effectively reduced levels of disability and perceived pain in chronic lower back pain . In post-surgical patients, chiropractic care could effectively improve lower back pain.
Chiropractic care is also lower in cost compared to conventional medical care for low back pain. A study by Liliedahl et al determined if there were differences in the cost of low back pain care when a patient is able to choose a course of treatment with a medical doctor (MD) versus a doctor of chiropractic (DC). The results showed that costs for chiropractic care were almost 40% less than medical care. Even after risk adjusting each patient's costs, chiropractic care was 20% less expensive than medical care.
With regards to adverse events, chiropractic care is believed to be a safe procedure. Rubinstein wrote that chiropractic care adverse events are benign and self-limiting. To quote, "The incidence of severe complications following chiropractic care and manipulation is extremely low. The best evidence suggests that chiropractic care is a useful therapy for subjects with neck or lower back pain for which the risks of serious adverse events should be considered negligible." Not everyone is suitable for chiropractic care, however, so that one should talk to a chiropractor first before undergoing this treatment modality for lower back pain.
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