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Chiropractic care for back pain

Some people with long-term back pain will consult a chiropractic treatment practitioner.

Chiropractic treatment is part of complementary and alternative medicine, or CAM.

The NHS says there is some good evidence that a chiropractor's spinal manipulation can be effective for persistent lower back pain.

What do chiropractors do?

Chiropractors use hands-on spinal manipulation and other complementary treatments, the theory being that proper alignment of the body's musculoskeletal structure, particularly the spine, will enable the body to heal itself without surgery or medication. Manipulation is used to restore mobility to joints restricted by tissue injury caused by a traumatic event such as falling or by repetitive stress such as sitting without proper back support.

Chiropractic is primarily used as a pain relief alternative for muscles, joints, bones and connective tissue such as cartilage, ligaments and tendons. It is sometimes used in conjunction with conventional medical treatment.

A chiropractor in the UK must take and pass a course accredited by the General Chiropractic Council (GCC) and then be registered with the GCC.

What does chiropractic care for back pain involve?

A chiropractor first records your medical history and then performs a physical examination. He or she may use lab tests or diagnostic imaging to determine if treatment is appropriate for your back pain.

The treatment plan may involve one or more manual adjustments in which the chiropractor manipulates the joints, using a controlled sudden force to improve range and quality of motion. Many chiropractors also incorporate nutritional counselling and exercise/rehabilitation into the treatment plan. The goals of chiropractic care include the restoration of function and prevention of injury in addition to back pain relief.

What are the benefits and risks of chiropractic care?

Spinal manipulation and chiropractic care is considered a safe effective treatment for acute lower back pain - the type of sudden injury that results from moving furniture or from a sudden jarring in sport. Acute back pain, which is more common than chronic pain, lasts no more than six weeks and typically gets better on its own.

Research has also shown chiropractic to be helpful in treating neck pain and headaches. Osteoarthritis and fibromyalgia also respond to the moderate pressure used by both chiropractors and practitioners of deep tissue massage.

Studies have not confirmed the effectiveness of prolotherapy or sclerotherapy for pain relief, used by some chiropractors, osteopaths and medical doctors to treat chronic back pain - the type of pain that may come on suddenly or gradually and lasts for more than six weeks. The therapy involves injections to strengthen loosely connected tendons and ligaments.

People who have osteoporosis, spinal cord compression or inflammatory arthritis, or who take blood-thinning medications, should not undergo spinal manipulation.

All treatment is based on an accurate diagnosis of your back pain. The chiropractor should be well informed regarding your medical history including ongoing medical conditions, current medications, traumatic/surgical history and lifestyle factors. Although rare, there have been cases in which treatment worsened a slipped disc, or neck manipulation resulted in a stroke or spinal cord injury. To be safe always inform your doctor whenever you use chiropractic or other pain relief alternatives.

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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on July 22, 2014

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