If you‘ve ever seen a doctor for back pain, you're not alone. An estimated 85% of people experience back pain severe enough to see a doctor for at some point in their life. Yet despite how common it is, the precise cause of pain is often unclear. And a single, best treatment for most low back pain is unknown.
” Standard care” includes a balance of rest, stretching and exercise, heat, pain relievers, and time. Some doctors also suggest trying chiropractic care. The good news is that no matter what treatment is recommended, most people with a recent onset of back pain are better within a few weeks often within a few days.
But many people with back pain see acupuncturists, massage therapists, or a chiropractor on their own. Experts disagree about the role of chiropractic care, and there are not many high-quality studies to consult about this approach. As a result, there are a number of questions regarding the role of chiropractic care: Should it be a routine part of initial care? Should it be reserved for people who don't improve with other treatments? Are some people more likely to improve with chiropractic care than others? The answers to these questions go beyond any academic debate about how good chiropractic care is.
With the backdrop of the opioid crisis, we badly need an effective, safe, and non-opioid alternative to treat low back pain. A 2018 study published in JAMA Network Open is among the latest to weigh in on the pros and cons of chiropractic care for treating low back pain. Researchers enrolled 750 active-duty military personnel who complained of back pain.
After six weeks of treatment, those assigned to receive chiropractic care: reported less pain intensity experienced less disability and more improvement in function reported higher satisfaction with their treatment needed less pain medicine. While no serious side effects were reported, about 10% of those receiving chiropractic care described adverse effects (mostly stiffness in the joints or muscles).
And this one is no exception. While this study suggests that chiropractic care may be helpful for low back pain, some aspects of the study make it hard to be sure. For example: It only lasted six weeks. As mentioned, most new-onset back pain is better by then regardless of treatment.
The differences in improvement between those receiving chiropractic and usual care were small. It's not clear how noticeable such a difference would be, or whether the cost of chiropractic care would be worth that small difference. The study included a mix of people with new and longer-standing low back pain and a mix of types of pain (including pain due to a pinched nerve, muscle spasm, or other reasons).
So, it's hard to generalize these results to everyone with back pain. What exactly does a chiropractor do?. Most of the study subjects were young (average age 31) and male (77%). All were generally healthy and fit enough to pass military fitness testing. Study subjects knew which treatment they were receiving. This creates potential for a placebo effect.
Then again, these factors may not matter to a person who just wants relief. This study only included people who were willing to receive chiropractic care. Even within the two groups, the care varied that is, not everyone in the usual care group received the same treatment, and this can also be said for the chiropractic group.
For example, it's possible that if an older population of people with chronic low back pain had been studied, “usual care” might have been the better treatment. This new study lends support for chiropractic care to treat low back pain. But it‘s important to recognize the limitations of this trial, and keep in mind that treatment side effects were more common among those receiving chiropractic care.
This won't be and shouldn't be the last study of chiropractic care for low back pain. But until we know more, I'll continue to offer it as one of many treatment options. Follow me on Twitter @RobShmerling Commenting has been closed for this post.
Help for your aches, pains, creaks and strains Share Mystified by chiropractors? You‘ve got a lot of company. Many people don't understand what a chiropractor does. Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.
It‘s important to inform your primary care physician about any pain you're experiencing, whether recent or chronic (lasting more than three months). Your primary care doctor can rule out potentially serious problems that need treatment. Chiropractors can complement the traditional medical care you receive. Here are three things you should know about what they do and don't do: “Chiropractors do not prescribe medication; this allows us to think outside the box,” says Dr.
” Many people would rather take a pill than change a few lifestyle habits, but I see finding an alternative approach as a huge positive because it empowers patients to take control of their health.” A chiropractor may prescribe:: To relax tight muscles, relieve spasm and release tension in the fascia (the connective tissue that surrounds each muscle) To gently realign joints and increase range of motion To support sprained joints or muscles as they heal: To restore and maintain mobility and range of motion: For guidance on diet and nutrition to reduce inflammation and promote weight loss “Treatments generally do not hurt.
Bang. “Over time, however, your muscles adjust. Chiropractors can treat pain anywhere in the body: in the head and jaws, the shoulders, the elbows and wrists, the hips and pelvis, and the knees and ankles. “We look at the whole musculoskeletal system and treat the root of the problem. We make sure not only that the joints are moving properly, but also that surrounding muscles are functioning well,” says Dr.
After your primary care physician has evaluated your pain, chiropractors can offer complementary care for many common problems: “A lot of headaches and migraines are caused by tension in the jaw,” Dr. Bang says. “Maybe patients are unaware that they clench their jaw at night. My job is to relieve jaw muscle tension to increase blood flow, which ultimately helps alleviate the headaches.” Podiatrists typically recommend orthotics and massage for temporary relief of this painful foot condition.
” Sometimes the knees or lower back are the real problem, affecting the way patients walk, which eventually leads to plantar fasciitis,” he says. If shoulder pain persists but an MRI shows no problem, chiropractors will assess the muscles surrounding the shoulder blade. They may also look for ribs that are restricted and prevent the shoulder from moving properly.
” Depending on the patient, the intensity and force of treatments vary,” says Dr. Bang. All patients are screened to ensure that they are good candidates for chiropractic care. For example, many older patients have some thinning or softening of the bones that would rule out joint manipulation. If chiropractic care is too risky for a patient, “we will guide them to the right people and resources,” says Dr.
The goal of chiropractic care is to restore your health over the long term, rather than to relieve your symptoms over the short term. So a chiropractor will ask how you move throughout the day (standing, sitting, walking) and how you sleep at night. Learning how to position your body at your desk, when you're standing and moving, and when you‘re in bed and incorporating stretches into your daily routine can be invaluable in preventing future problems.
Chiropractors attend graduate-level health colleges to treat disorders of the bones, nerves, muscles, and ligaments. They graduate as doctors of chiropractic degrees, but they are not medical doctors. What exactly does a chiropractor do?. While chiropractors are widely known for treating back and neck pain, they also treat bone and soft tissue conditions. In this article, we explore myths and truths of chiropractic care.
A common myth is that chiropractors do not undergo a significant amount of training. In fact, they typically complete about 8 years of higher education before they are licensed. Chiropractors tend to have 4 years of undergraduate education. They usually graduate with a pre-med major after having taken courses in sciences, such as biology, chemistry, psychology, and physics.
On average, these involve 4 years of education with a total of 4,200 instructional hours in course credits. Divided by year, a chiropractic graduate program usually involves:: Courses in general anatomy, chiropractic principles, biochemistry, spinal anatomy.: Courses in chiropractic procedures, pathology, clinical orthopedics, imaging interpretation, and research methods.: Courses in clinical internships, integrated chiropractic, pediatrics, dermatology, practice management, and ethics and jurisprudence.: A clinical internship, in which a student studies under a chiropractor and completes rotations in a hospital or veterans' clinic.
After completing the educational and training requirements, an aspiring chiropractor in the United States will sit for their state licensing board. Once they have obtained licensure and certification from the board, they will become a doctor of chiropractic. Chiropractors often receive additional training and certification in a wide variety of specialties, including nutrition, sports medicine, acupuncture, and rehabilitation.
Another common myth is that a chiropractor merely cracks a person's back or bones. Chiropractic care is centered around spinal manipulation. However, practitioners also study how the spine and its structures are related to the body's function. A majority of a chiropractor's work involves making adjustments to heal: lower back painwhiplash-related conditionsneck painThey may also provide services such as postural testing and analysis, as well as others designed to promote nutrition and healthful exercise.
An estimated 74 percent of Americans with pain in this area have used chiropractic care at some point in their treatment – What exactly does a chiropractor do?. Results of a 2010 review cited by the center suggest that spinal manipulation may be useful for treating back pain, migraine headaches, whiplash, and other conditions affecting the upper and lower extremities.
Sessions should be tailored to a person's needs and performed by a licensed chiropractor. Several myths surround this question. One myth is that chiropractors only treat back pain. In fact, chiropractic care can also help to heal pain in the foot, elbow, shoulder, and neck. The same review cited by the National Center for Complementary and Integrative Health concluded that chiropractic treatment is not useful in treating: Authors of the review failed to find definitive evidence that chiropractic care treated musculoskeletal conditions, such as fibromyalgia, temporomandibular joint disorders, and mid-back pain.
A chiropractor will usually perform an X-ray to ensure that treatment will not worsen a traumatic injury. Studies suggest that chiropractic methods are viable options for managing pain. A 2018 review included 17 years of studies involving spinal manipulation and mobilization, which is a more passive form of manipulation. The studies investigated the effects of these treatments on chronic lower back pain, and the authors concluded that the chiropractic methods were “viable” options for pain management.
The authors concluded that treatment improved both function and pain for up to 6 weeks. The American College of Physicians recommend that those with lower back pain use a variety of non-pharmacological treatments, including spinal manipulation. Researchers generally agree that more studies are needed to determine the ideal length and frequency of chiropractic sessions and to identify what injuries may benefit from specific treatments.
A person may experience side effects of spinal manipulation, including: There have been occasional reports of long-term danger related to chiropractic care. The National Center for Complementary and Integrative Health reports that severe complications may include worsening pain and cauda equina syndrome, which involves nerve damage in the lower spinal cord.
The World Health Organization (WHO) state that it is unsafe for people with certain health conditions to undergo chiropractic manipulation. These conditions include: bone disease and infectionsbroken bonesinflamed joints, such as in cases of rheumatoid arthritissome circulation problemsinfections of the nervous systemAn aspiring chiropractor must spend thousands of hours studying before obtaining a license – What exactly does a chiropractor do?.
Chiropractic care is drug-free and non-invasive, and it may treat some musculoskeletal problems – What exactly does a chiropractor do?. While this form of alternative medicine may not benefit everyone, it is generally considered safe for most people.