Spinal Manipulation and the Treatment of Lower Back Pain

By Dr. Chris Gubbels

When it comes to lower back pain, patients have a wide array of treatments from which to choose. One recent survey reported that there are approximately 200 treatments for back problems [1].

Of all reviewed methods of lower back therapies, however, only chiropractic care involving spinal manipulation and supporting treatments is the preferred method of reducing and eliminating lower back pain [2].

According to a 2013 survey by Consumer Reports, 59% of participants who saw a chiropractor to resolve lower back pain were highly satisfied compared to 55% of participants who saw physical therapists. Only 34% of those seeing a primary care physician reported being highly satisfied with treatment.

Still, some health practitioners are hesitant to support chiropractic spinal manipulation despite numerous studies supporting chiropractic care.

Part of this hesitation may be due to a lack of understanding of the specific biological pathways involved with these therapies. Studies suggesting that the repositioning of disc material, reducing muscle tension or stiffness, freeing adhesions around a prolapsed disc, and mechanical stimulation that inhibits transmission of nociceptive impulses are likely reasons why chiropractic treatment is so effective [3].

In contrast, pharmacological approaches, where the biological pathways are well understood, have been shown to produce adverse effects in some patients. For example, among patients taking nonsteroidal anti-inflammatory drugs, renal function abnormalities occur in approximately 1% of patients [4]and superficial gastric erosions or asymptomatic ulcers may occur in up to 5% to 20% of users [5]

Relying on pharmacological approaches can also bring additional risk, such as the use of opioids to relieve lower back pain. Patients prescribed opioids to treat lower back pain risk becoming long-term opioid users, with associated risks of dependency, addiction, and overdose.[6][7]

When you factor in the costs of caring for complications from pharmacologic therapies (societal cost of opioid abuse, healthcare and workplace costs), conventional care loses its appeal. By contrast, studies show that patients who seek chiropractic care for lower back pain don’t incur higher overall treatment costs than conventional care.[8]

Seeking treatment for lower back pain is an important decision. Spinal manipulation, coupled with related treatments applied by a chiropractor in Orange City, is the best path to reducing or eliminating lower back pain while improving function.

About The Author
Dr. Chris Gubbels is a Fort Collins Chiropractor and owner of Square ONE Advanced Spine Correction. He has been published in peer reviewed scientific journals, presented cases at scientific research conferences and holds advanced post graduate training in spine biomechanics, scoliosis treatment, personal injury and wellness.

References
1. Haldeman S, Dagenais S. A supermarket approach to the evidence-informed management of chronic low back pain. Spine J. 2008;8(1):1-7.
2. Deyo, Richard A, The Role of Spinal Manipulation in the Treatment of Low Back Pain. JAMA. 2017 Apr 11;317(14):1418-1419.
3. Meeker WC, Haldeman S. Chiropractic. Ann Intern Med. 2002;136(3):216-227.
4. Whelton A, Hamilton CW. Nonsteroidal anti-inflammatory drugs: effects on kidney function.J Clin Pharmacol. 1991;31(7):588-598
5. Vonkeman HE, van de Laar MAFJ. Nonsteroidal anti-inflammatory drugs: adverse effects and their prevention. Semin Arthritis Rheum. 2010;39(4): 294-312.
6. Deyo RA, Hallvik SE, Hildebran C, et al. Association between initial opioid prescribing patterns and subsequent long-term use among opioid-naïve patients.J Gen Intern Med. 2017;32(1): 21-27. 13.
7. Edlund MJ, Martin BC, Russo JE, DeVries A, Braden JB, Sullivan MD. The role of opioid prescription in incident opioid abuse and dependence among individuals with chronic noncancer pain: the role of opioid prescription. Clin J Pain. 2014;30(7):557-564.
8. Martin BI, Gerkovich MM, Deyo RA, et al. The association of complementary and alternative medicine use and health care expenditures for back and neck problems. Med Care. 2012;50(12):1029- 1036.