Chiropractic for low back pain

Acute low back pain is that sudden low back pain that starts just after you lift a heavy object, move suddenly, sit in one position for a long time, or have an accident.  

However, many times, acute low back pain can come appear for no identifiable reason – one may bend over and feel a sharp knife of pain in your low back.  

Acute low back pain is most often caused by a sudden injury to the joints, muscles, ligaments, bones, and/or nerves in the spine. Acute low back pain is defined as low back pain that lasts from just a few days to weeks – if it lasts longer than that, it is considered chronic.

Low back pain is the number two reason that Americans see their medical doctor, second only to colds and flu’s. If you haven’t experienced a bout of low back pain yet, just be patient, odds are it is only a matter of time.

This means that a study showing one form of back treatment is superior to another, health professionals take notice.

When that study is published in the prestigious The Spine Journal, and it compares chiropractic care to medical care for acute low back pain, you can bet your chiropractor, medical doctor, and insurance provider is interested.  

The December 2010 issue of the The Spine Journal has published the Chiropractic Hospital-based Interventions Research Outcomes Study.

This study concludes that patients with acute mechanical low back pain enjoy significant improvement with chiropractic care, but little or no improvement with treatment from a family physician.

The study followed patients for 16 weeks of treatment, and found those under medical care saw almost no improvement in their disability scores, were likely to be still taking pain drugs and saw no benefit with added physical therapy.

These same people were also unlikely to be referred to a doctor of chiropractic.

This high quality study (randomised control trial) compared chiropractic spinal manipulative therapy administered by a chiropractor to medical care for those patients suffering from acute mechanical low back pain.

The researchers found that “treatment including chiropractic spinal manipulative therapy is associated with significantly greater improvement in conditions-specific functioning” than usual care provided by a family physician.

The patients in the chiropractic care group received acetaminophen (Tylenol, Paracetamol), a walking programme, and four weeks of chiropractic manipulative therapy.

Those patients in the medical care group received a variety of treatments ranging from prescriptions, massage therapy, and/or physiotherapy.

Both groups showed improvement in bodily pain and physical functioning, but patients in the medical group showed no improvement whatsoever in back-specific functioning throughout the entire study period.

Interesting finding
A very interesting finding of the study was that when the medical group of patients received Tylenol and manipulation performed by a physiotherapist, their treatment was still not as effective as chiropractic care.

The study found that spinal manipulative therapy and Tylenol administered by a physiotherapist to have no clinical worthwhile benefit compared to just Tylenol alone.

The study noted that although many different healthcare professionals utilise spinal manipulative therapy (chiropractors, osteopaths, physiotherapists) the levels of training and clinical experience varied greatly.

Only a trained chiropractic physician can provide a proper chiropractic manipulation, and current guidelines for care does not endorse any forms of spinal manipulation administered by any other practitioners.

This is only one study and there will be many more. However, for the time being, it certainly validates chiropractic care as the most effective choice for treating acute low back pain.

This does not mean that every case of acute low back pain is best served by chiropractic exclusively.  

An effective chiropractor, just like any other type of healthcare provider, is one who works as part of healthcare team.

There certainly are episodes of acute mechanical low back pain that will need medical attention and your chiropractor will need to make the referral when required.

In Cayman, we are lucky to enjoy a healthcare community that largely works together as team for the ultimate benefit of the patient.

Dr. Jemal Khan is a chiropractor based in the Cayman Islands.


Low back pain can last a few days to several weeks.