Low back pain is common and debilitating. As many as 80 percent of adults experience this distressing condition sometime during their lives. Physicians often recommend nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen to ease the pain. They may also treat excruciating back spasms may with opioids and or muscle relaxants. In addition, they often recommend exercise or physical therapy. Are doctors overlooking spinal manipulation?
Chiropractic Care Reduces Chance of Back Surgery:
Although physicians are often skeptical about the care chiropractors offer, a study from University Hospitals Cleveland has found advantages. People who see a chiropractor when they first experience low back pain are less likely to get back surgery over the next two years (BMJ Open, Dec. 16, 2022).
The researchers reviewed health records between 2012 and 2022 and excluded patients with urgent indications for surgery. They compared 5,785 people who got chiropractic spinal manipulation and an equal number who got other medical care for low back pain. After two years, fewer than 2% of those in the chiropractic group had received lumbar discectomy. In comparison, 2.4% of patients getting other types of care had spinal surgery.
Is There Value in Spinal Manipulation for Back Pain?
In the past many doctors have been ambivalent or even hostile about spinal manipulation. Edzard Ernst is a physician who has focused on complementary medicine. His article in Spectator Health (Feb. 18, 2016) was titled:
“The evidence shows that chiropractors do more harm than good”
Dr. Ernst states unequivocally that “the published evidence [of chiropractic claims] generally reveals these claims to be little more than wishful thinking.”
He goes on to state:
“There is now a lot of evidence showing that more than half of all patients suffer mild to moderate adverse effects after seeing a chiropractor.”
Steven Salzberg, PhD, is the Bloomberg Distinguished Professor of Biomedical Engineering, Computer Science, and Biostatistics at Johns Hopkins University.
Writing in Forbes (Feb. 12, 2018) he states:
“Most people think that chiropractors’ spinal ‘adjustments’ can relieve pain from injured or aching backs. It turns out that it’s just an elaborate placebo: a back rub at home is likely to work just as well.”
We could go on and on, but you get the picture. Mainstream medicine is not a fan of spinal manipulation.
Study Supports Spinal Manipulation:
The study from University Hospitals Cleveland is not the first to suggest benefits from chiropractic care. A previous study showed that spinal manipulation can be highly effective (BMJ, online, March 13, 2019). Please note that this is not a shady pseudoscientific publication. The BMJ (formerly the British Medical Journal) is highly regarded as a trusted resource.
The researchers analyzed 47 studies that included over 9,000 adults. Spinal manipulation was equally as effective as NSAIDs, pain medicines and exercise. As a result, the investigators urged medical doctors to consider chiropractic and other forms of spinal manipulation for lower back pain.
In their own words, the authors state:
“SMT [spinal manipulative therapy] produces similar effects to recommended therapies for chronic low back pain but results in clinically better effects for short term improvement in function compared with non-recommended therapies, sham therapy, or when added as an adjuvant therapy.”
What About Adverse Effects?
The researchers devoted quite a bit of effort to the issue of complications from such care. They admitted that this can be hard to assess.
They summarized their findings this way:
“Based on a recent systematic review, serious adverse events after SMT for low back pain are thought to be rare and include case reports of cauda equina syndrome, fractures, and neurological or vascular compromise.”
“The body of evidence, which includes data from large, prospective observational studies of SMT, suggests that benign adverse events are common and serious adverse events are rare.”
What’s Your Experience?
Have you ever had spinal manipulation? How did it work for you? Did you experience any adverse events? Please share your story in the comment section below.
