Back pain is a common condition, affecting 8 out of 10 people at some point during their lives. The pain can range from a persistent dull ache to sudden sharp pain. In most cases, back pain occurs due to muscle or ligament strain or some form of injury to the spine, bones or disc. Other causes include incorrect posture, heavy or strenuous work, specific abnormalities of organs within the abdomen or chest. Back pain can be acute and last for a short time, or chronic and persist for 12 weeks or longer. Back pain treatment depends on whether the pain is acute or chronic.
According to a new study, spinal manipulation therapy may modestly improve pain and function in patients with acute low back pain. Published online in JAMA on April 11, 2017, the study reported that spinal manipulative therapy (SMT) treatments for acute low back pain were associated with statistically significant benefit in pain and function at up to 6 weeks, that was, on average, clinically modest.
Researcher Paul G. Shekelle, (M.D of the West Los Angeles Veterans Affairs Medical Center, Los Angeles) and his colleagues conducted a review and meta-analysis of previous studies to assess the effectiveness and harms associated with spinal manipulation when compared to other non-manipulative therapies for adults with acute low back pain. Researchers pointed that the amount of benefit was about the same as for non-steroidal anti-inflammatory drugs (NSAIDs).
Low back pain is one of the leading causes of disability and physician visits worldwide. Often, the pain decreases within a few weeks. But when it persists, it is treated with different pain management techniques such as spinal manipulation, physical therapy, exercise and medications like painkillers or muscle relaxers, though none have proven superior to any other. Past reviews of spinal manipulation have yielded conflicting evidence about its effectiveness for low back pain.
As part of the review, researchers searched four different databases for studies about spinal manipulation in the treatment of acute low back pain, with a follow-up of 6 weeks or shorter. The analysis, which included 26 studies published between January 2011 and February 2017, excluded patients with sciatica and chronic low back pain.
The study team found that the spinal manipulation technique resulted in more meaningful reductions in pain and improvements in function after six weeks of treatment. The effect on pain was modest and quite similar to what other studies have found with non-steroidal anti-inflammatory drugs (NSAIDs).
Performed by chiropractors, spinal manipulation or chiropractic adjustment involves using the hands or a special device to apply a gentle force to relieve the stress on the vertebral column and curves of spine. Correcting misalignments and relieving pressure on the nerves and tissue structures improves back pain.
The researchers concluded that the extent of the benefit of the spinal manipulation technique for acute low back pain is about the same as the benefit from non-steroidal anti-inflammatory drugs. The study incorporates the most recent data and confirms that spinal manipulation is at least effective as conventional care.