New Medical Approach to Back Pain

Since the early 1990s there has been a fundamental change in medical management of patients with low back pain, broadly adopted since the publication of authoritative national practice guidelines in the U.S.1 and the U.K.2 in 1994.

The guidelines change the approach from rest and “wait-and-see” to maintaining daily activities and earliest possible rehabilitation. The first line of treatment is manipulation and simple non-prescription medication, and the guidelines encourage GPs to refer patients for skilled manipulation.

As a result of the government-sponsored guidelines, developed by multidisciplinary expert panels, there is new common ground between chiropractic and the medical profession. While there are some medical doctors opposed to chiropractic, acceptance by the family GP is becoming more apparent and seems to be paralleled to the increasing use of chiropractic in the community. A study from the Medical Journal of Australia in 2000 revealed that 69% of GP’s have referred patients to a chiropractor. Forty-one per cent of these refer a few times a year and 17% refer at least monthly.3

“Chiropractors were once dismissed as crackpots. Now even medical doctors call them your back’s best hope.” - Carey, Medical Doctor 4

At Shirley Rd Chiropractic we have always worked very closely with GPs and the medical profession. Many of these medical doctors, having themselves suffered back or neck pain, are now patients realising the benefits of care. They are also often surprised at how gentle and mild the treatment may seem for its overall effectiveness. We believe that each profession has a complementary and important role.



  1. Bigos, S., Bowyer, O., Braen, G. et al. (1994) Acute low back problems in adults. Clinical practice guideline no. 14. Rockville, Maryland: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services: AHCPR Publication No. 95-0642.
  2. Rosen, M., Breen, A. et al. (1994) Management guidelines for back pain. Appendix B In: Report of a clinical standards advisory group committee on back pain. London, England: Her Majesty’s Stationery Office (HMSO).
  3. Pirotta, M.V., Cohen, M.M. et al. (2000) Complementary therapies: have they become accepted in general practice? MJA 172: 105-109.
  4. Carey, B. (1998) Back magic. Health. May/Jun: 108-112.