Spinal Manipulation Provides Modest Improvement for Acute Low Back Pain

Spinal Manipulation Provides Modest Improvement for Acute Low Back Pain

By Staff

People who suffer from acute low back pain can gain modest improvements in pain relief, as well as function, through spinal manipulation, says a study published in JAMA.

According to The JAMA Network Journals’ announcement, back pain is among the most common symptoms prompting patients to seek care. Lifetime prevalence estimates of low back pain exceed 50 percent. Treatments for acute back pain include analgesics, muscle relaxants, exercises, physical therapy, heat, spinal manipulative therapy (SMT) and others, with none established as superior to others.

Paul G. Shekelle, M.D., Ph.D., of the West Los Angeles Veterans Affairs Medical Center, Los Angeles, and colleagues conducted a review and meta-analysis of previous studies to assess the effectiveness and harms associated with spinal manipulation compared with other non-manipulative therapies for adults with acute (six weeks or less) low back pain.

Of 26 eligible randomized clinical trials (RCTs) identified, 15 RCTs (1,711 patients) provided moderate-quality evidence that SMT has a statistically significant association with improvements in pain. Twelve RCTs (1,381 patients) produced moderate-quality evidence that SMT has a statistically significant association with improvements in function.

No RCT reported any serious adverse event. Minor transient adverse events such as increased pain, muscle stiffness, and headache were reported 50 percent to 67 percent of the time in large case series of patients treated with SMT. Differences in study results was large, and was not explained by type of clinician performing SMT, type of manipulation, study quality, or whether SMT was given alone or as part of a package of therapies.

The authors write that the size of the benefit of SMT for acute low back pain is about the same as the benefit from nonsteroidal anti-inflammatory drugs, according to the Cochrane review on this topic.

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Authored by: Staff

There are 5 comments for this article
  1. Kathy C at 5:34 pm

    Mary, there are a lot of us out there. I really wish i could say something positive or encouraging. I wish there was some way to tally the damage done by irresponsible Chiropractors. I filed a Complaint years ago, and they never followed up. There seem to be a lot of us out there, but the current “Studies” don;t mention the mistakes. I am fairly certain Chiropractors made my Ruptured Disc worse, but I went out of desperation. The Disc at the L5, S-! was so badly mangled, the disc materiel went into the nerve root. It took over five years for a diagnosis and by the end my leg was nearly paralyzed. No Chiropractor would ever turn down a Payment for their Quackery. I know a woman who saw her Chiropractor For “Back Pain” for 2 years, the pain was actually Kidney cancer.

  2. Mary Stephenson at 6:51 am

    I was injured with a sideway whiplash c5-c6. The chiropractor blew 1 disk into 3 broken pieces. 2 floated in my spinal canal and the other piece wedged into nerve root at c5-c6 causing RSD and injured my right arm forever. Took 22 months to figure why I had a baseball size lump on my right shoulder. Still there but not as big after all the injections, pt, biofeedback, massages, acupuncture, so much more. I’m still in pain 24-7-365 and live on pain pills and muscle relaxers. I was only 33 when I got hurt, but took Drs 22 months to figure out what happened to my neck, shoulder, face, spine, horrible nerve damage. The results was an impinged reaped chunckbof disk on my nerve root leaving huge lump that did a lot of damage. I turn 64 on May 8, Monday been living in pain all these years because the chiropractor swung my neck so hard from side to side I’m damaged forever. 2 neck surgeries and life changed in less than 2 seconds that day the chiropractor gave me a sideway whiplash. I live in chronic pain syndrome.
    Now the government is going to finish me off by taking my only quality of life of about 50-65% pain free with my opioids pain medication. It’s temporary but I get reliev for awhile. My dr. Asked me quality or quantity of live. I chose quality verses quantity.
    My life changed in a second or two. I have no children my spine specialist said I would drop my babies, I break my dishes, chip them, crack them too heavy to put in cabinets. Plus so much more injurynumb, can’t walk, can’t pick up , can’t do anything normal, this is my life in chronic pain syndrome 24-7-365. Lost a lot of everything. But I get up or try to get out of bed everyday and do something so as I not s vegetable in a chair. So 1/2 my life has been chronic from an irresponsible chiropractic.

  3. Kahty C at 1:20 pm

    This makes it all appear “Scientific.” They just leave out the facts, a convenient way to mislead the public. Unless they did a very good examination before they allowed these subjects in the Trial, there is no way to distinguish the severity of the “Back Pain.” There is also no way to know if any of these people had any kind of underlying Spinal Injury. In general most people have no idea if they have an underlying issue, or if they are merely “Stressed” or spend to much time at a desk. These Studies make no mention of that significant information. There is no way to track the number of people who are injured by Chiropractors either , or who had a spinal problem made even worse by Chiropractors. Physicians found that Chiropractors help them avoid Liability.
    Since there is no requirement to report Chiropractic Injuries, the only possible way to track their occurrence is by the Chiropractic Board, which is not in the business of collecting data, or even responding to complaints. If people were injured by a Chiropractor there would be no way to know. This is how they deliberately mislead the public, on everything. If there is on Agency tracking any of this, and no Reporting Requirements, these “Studies” are meaningless.
    While working in a Chiropractors Office for a short time, I found that they do not report anything, even to the Patients. A woman came in with “Post Surgical “Foot Pain.” and they actually did a “Treatment” on her in spite of the fact that she was very close to Septic. The pain was from a Post Surgical Infection, which needed immediate Medical Attention. Instead of telling her to go to her Physician Immediate they just treated her and sent her on her way. I was mortified, I offered to call her or even go to her home. The Chiropractor made it pretty clear that no one in the office was to contact her. The Incisions were weeping Pus. The woman did not “Believe In” conventional Medicine, instead she chose to go to her “Alternate” Physician. We are now in the Post Fact Era, her Physician might have even recommended the Chiropractor for “Pain.” It did not matter that the Pain was because she did not take her Antibiotics after a foot surgery. After all, they aren’t “natural” she probably believed that her Alternative Medicine made the Antibiotics unnecessary. They hype supplements and “alternative medicine that stimulates the immune System. People like that truly believe is works. The Physician was probably relived that the Infection was not his fault. The “System” has no way to track these “Adverse Events” by design.

  4. connie at 2:57 pm

    Chiropractic care helps some pain some of the time. It’s not the cure all that some would like you to believe.

  5. Mark Ibsen at 8:24 am

    Bob Dylan wrote:
    “You don’t need a weatherman to tell which way the wind blows”
    And
    You don’t need an RCT to apply the Scientific model to the care of each and every individual patient, something that has been lost in my beloved profession.
    Of course chiropractic care helps. Just ask the patients!

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