Efficacy of Chiropractic Care for Back Pain: A Clinical Summary

An article with the above title was published in the March 2019 issue of Practical Pain Management. The article gave an updated overview on low back pain management and was written by researchers who had been involved in previous studies on lower back pain and chiropractic.

The article begins by noting how common back pain is. "A 2018 Gallup study found that over 60% of US adults report having experienced back or neck pain severe enough to require care from a healthcare provider at some point in their lives, with 25% seeking such care within the past year." The article points out that lower back pain, (LBP) is the most common musculoskeletal condition that triggers medical treatment.

Unfortunately, the authors point out that medical care usually consists of NSAIDs, steroid injections, spinal surgery, and opioids, all of which have been shown to not be very effective and which carry significant side effects. With the current opioid crisis getting worse, alternatives are being seriously considered. The article reports, "Spurred on primarily by the resultant opioid crisis, many government and private organizations, including the FDA, the Joint Commission, and the American College of Physicians are now recommending the use of non-drug, non-surgical therapies for chronic pain, including low back pain." Chiropractic is one of those recommended strategies of care.

Currently, Doctors of Chiropractic are licensed as primary portal of entry health care practitioners in all 50 U.S. states. This means that it does not require a referral to seek care from a chiropractor. Chiropractic care does not involve medications or surgery of any kind. According to the article, a recent Gallup study showed that over half of U.S. adults have received chiropractic care at some point, with approximately 15% having seen a chiropractor within the past year.

One of the studies reviewed in the Practical Pain Management article was a clinical trial titled "Effect of Usual Medical Care Plus Chiropractic Care vs Usual Medical Care Alone on Pain and Disability Among US Service Members with Low Back Pain." This study, which was conducted at three military locations, was published in the Journal of the American Medical Association Network Open.

At each of the military locations, 275 volunteers were divided into two groups. One group got usual medical care, while the other group also received chiropractic care. At all three sites, the results of the study showed that those who also got chiropractic care did statistically better that those that only received medical care. It should be noted that the study did not include a group that only received chiropractic care without the addition of medical care. There are those that would argue that medication could actually slow the progress of patients under chiropractic care. They maintain that chiropractic by itself may have gotten better clinical results for patients than when combined with medications.

In their discussion, the authors of the article noted, "These findings have the potential to impact clinical practice by strengthening the scientific literature regarding the use of chiropractic care in patients with LBP in the military and beyond." They concluded, "This large multi-site pragmatic comparative effectiveness study found that adding chiropractic care to usual medical care resulted in better participant outcomes."