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Spinal Manipulation Can Ease Low Back Pain

A meta-anlysis of controlled trials shows that spinal manipulation works as well as NSAIDs or exercise to help chronic lower back pain.
Spinal Manipulation Can Ease Low Back Pain
Chiropractor doing pushing motion to adjust back

Low back pain is common and debilitating. It is estimated that 80 percent of adults will experience this distressing condition sometime during their lives. Physicians often recommend nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen to ease the pain. Excruciating back spasms may also be treated with opioids and or muscle relaxants. Exercise and physical therapy are other frequent recommendations. Are doctors overlooking spinal manipulation?

Is There Value in Spinal Manipulation for Back Pain?

Many doctors have been somewhat ambivalent about spinal manipulation. Some are downright hostile. 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. There is a lot of resistance to spinal manipulation by mainstream medicine.

A New Study Supports Spinal Manipulation:

A new study shows 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. 

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The researchers analyzed 47 studies that included over 9,000 adults. Spinal manipulation was equally as effective as NSAIDs, pain medicines and exercise. 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 admit that this is hard to assess because the quality of the data is not great. They summarize 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.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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  • Rubinstein, SM, et al, "Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: Systematic review and meta-analysis of randomised controlled trials." BMJ, March 13, 2019. doi: https://doi.org/10.1136/bmj.l689
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