Need to see a chiropractor for low back pain? – Harvard Medical Letters


If you have ever seen a doctor for back pain, you are not alone. About 85% of people experience severe back pain that they see a doctor at some time in their lives. And though it is common, the exact cause of the pain is often unclear. And one, the best treatment for low back pain is not known. For these reasons, the recommendations of physicians seem to vary. “Regular care” includes balance of relaxation, stretching and exercise, heat, pain relief, and time. Some doctors also suggest attempts at chiropractic care & # 39; The good news is that regardless of the recommended treatment, for most people the onset of back pain is better within a few weeks – usually within days.

What is the role of chiropractic care & # 39;?

Some doctors send pain meds to the doctor immediately. But many people with back pain see acupuncturists, massage therapists, or chiropractors alone. Experts disagree on the role of chiropractic care & # 39 ;, and there are not many high-quality studies to be considered in this approach. As a result, there are a number of questions about the role of chiropractic care & # 39 ;: Is it part of routine care? Is it kept for people who are not good at other treatments? Is it possible for some people to make progress in chiropractic care & # 39; compared to others?

The answers to these questions will bypass any scholarly discussion of how good & # 39; chiropractic care & # 39; Estimates say low back pain costs up to $ 200 billion a year in the United States (including costs of care and missed work), and is the leading cause of disability worldwide. For post-opioid withdrawal disorders, we badly need a practical, safe, and non-opioid alternative to treat low back pain.

A recent study of chiropractic care & # 39; for low back pain

A 2018 study published JAMA Network Open is one of the latest to weigh out the benefits of & # 39; chiropractic care & # 39; for the treatment of low back pain. Investigators were registering 750 active military personnel complaining of back pain. Half were randomly assigned to receive routine care (including medication, self-care, and physical therapy) while the other half received routine care including 12 treatments & # 39; chiropractic & # 39 ;.

After six weeks of treatment, those assigned to receive chiropractic care & # 39;

  • reported less pain
  • Less disability and more development that works
  • reported high satisfaction with treatment
  • needed a little pain medication.

Although no serious side effects have been reported, about 10% of chiropractic care & # 39; characterized by unpleasant side effects (usually the stiffness of the joints or muscles). Five percent of people who receive regular care have similar complaints.

All education has limits

And this is an exception. Although this study suggests that chiropractic care & # 39; can help with low back pain, some aspects of the study make it difficult to check. For example:

  • It only took six weeks. As I mentioned before, most new back pain is better then no matter what treatment. For those with chronic back pain, we need more than six weeks of study.
  • The difference in improvement between those receiving care called & # 39; chiropractic & # 39; and standard care was scarce. It is unclear how this variant might appear, or whether the cost of chiropractic care & # 39; it will be worth that little difference.
  • The study included a combination of people with a new and long back pain and a combination of various types of pain (including pain due to a vein, muscle, or other causes). If this study were to be applied only to people with musculoskeletal disorders, or people who are overweight (rather than military recruits), the results may vary. Therefore, it is difficult to give these general results to anyone with back pain.
  • The majority of the study subjects were young (average age & # 39; age 31) and male (77%). All of them were generally healthy enough to fail military military fitness tests.
  • The study subjects identified the treatment they were receiving. This creates a potential for impact. Also, increased time and attention (rather than the use of a spinal cord strategy) may contribute to performance. Again, this may not apply to the person who just wants help.
  • This study included only people who wanted to receive chiropractic care & # 39;
    Even between the two groups, the care varied – that is, not everyone in the usual care group received the same treatment, this can also be said for the chiropractic & # 39; .

If any of these points would have been different, the results might have been different. For example, it is possible that if elderly people with low back pain were educated, "routine care" would be the best treatment.

Bottom line

The new study supports chiropractic care & # 39; to treat low back pain. But it is important to recognize the limitations of this court, keeping in mind that the effects of treatment are often greater in those who receive & # 39; chiropractic care & # 39 ;. In addition, chiropractic treatment & # 39; it is not free & # 39; not (though, fortunately, insurance for & # 39; chiropractic care & # 39; has become more common).

This will not be – nor will be – the latest study for chiropractic care & # 39; for low back pain. But until we know more, we will continue to offer it as one of many treatment options.

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