BETHESDA, Md. — Back pain is one of the most common health complaints, affecting eight out of 10 people at some point during their lives. The lower back is the area most often affected.
Spinal manipulation may be used by chiropractors, osteopathic physicians, naturopathic physicians, physical therapists, and some medical doctors with a goal of relieving low-back pain and improving physical functioning. These health professionals perform spinal manipulation by using their hands or a device to apply a controlled force to a joint of the spine. Most often they also recommend self-care practices.
But, what does the science tell us?
According to the National Center for Complementary and Alternative Medicine, most acute low-back pain gets better quickly with self-care practices, such as applying heat, using a firm mattress, doing back exercises, or taking pain medications.
Overall, studies have shown that spinal manipulation is one of several options — including exercise, massage, and physical therapy — that can provide some individuals with mild-to-moderate relief from low-back pain.
Spinal manipulation appears to work about as well as these other treatment approaches.
In 2007 guidelines, the American College of Physicians and the American Pain Society included spinal manipulation as one of several complementary treatment options (others include massage and acupuncture) for practitioners to consider when low-back pain does not improve with self-care.
A 2010 Agency for Healthcare Research and Quality (AHRQ) report noted that complementary health therapies, including spinal manipulation, offer additional options to conventional treatments, which often have limited benefit in managing back and neck pain.
Reviews of the science have concluded that spinal manipulation for low-back pain is relatively safe when performed by a trained and licensed practitioner.
The most common side effects are generally minor and include feeling tired or temporary soreness.
There have been some reports of more serious side effects, but it is unclear if they are actually associated with spinal manipulation.
It’s important to note that there may be additional risks associated with spinal manipulation affecting the upper (cervical) spine, but that area of the spine is generally not manipulated when treating low-back pain.
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