Chiropractic and Back Pain
There has been clear evidence from many studies that has confirmed the effectiveness of chiropractic manipulation, and chiropractic management, for patients with mechanical low back pain (also called common, simple or non-specific back pain), the type of back-pain suffered by over 90% of patients.1-6
The most influential trial because of its size, scientific design, independence, and results has been one by Meade that was published in the British Medical Journal in 1990, with long-term results published in 1995. This trial was also important because it gave positive answers to two questions asked by many medical doctors:
- Are the benefits of chiropractic treatment long-term as well as short-term?
- Is chiropractic treatment valuable for patients with chronic pain?
The Meade trial compared chiropractic and medical management as actually experienced by patients in normal life. In summary:
- The study involved 741 patients in a randomised, controlled trial by medical researchers funded by the British Medical Research Council. The study compared standard chiropractic and medical/physiotherapy (hospital outpatient back pain clinics) treatment for patients with low back pain of mechanical origin. A maximum of 10 treatments was allowed over a 3 month period.
- Measurement of results was both objective and subjective and was done at 6 weeks, 6 months, 1 year and 2 years (i.e. during and long after completion of treatment).
- The chiropractic patients did significantly better, including those with severe or chronic pain, and these superior results were maintained after 1 and 2 years.
- Meade concluded that chiropractic treatment had long-term success in the management of patients with mechanical back pain, was highly cost-efficient and should be funded within the British National Health System.
What structures cause common back pain?
Common acute back pain is due to chemical abnormalities created by a soft tissue tear. The tear represents a mechanical disruption which is usually microscopic.7 The tear is normally in the muscle fibres and/or ligaments.8 While X-Rays often demonstrate no changes after an acute back pain injury they may help the chiropractor identify the cause of the injury.
Recurrence of Back Pain
In a study of 373 patients under 40 years of age, 89% had a recurrence within 10 years and only 33% had no lost time from work from future back problems.9 Another study suggests that two thirds of the people who have had back pain in the past can be expected to have some symptoms every year.10
While this all sounds very negative it is our goal at Shirley Rd Chiropractic to work with people in such a way that helps to minimize recurrences and help people take a more pro-active role in their care.
- Hadler, N.M., Curtis, P., et al. (1987) A benefit of spinal manipulation as adjunctive therapy for acute low back pain: a stratified controlled trial. Spine 12: 703-706.
- Meade, T.W., Dyer, S. et al. (1990) Low back pain of mechanical origin: a randomised comparison of chiropractic and hospital outpatient treatment. British Medical Journal 300: 1431-1437.
- Meade, T.W., Dyer, S. et al. (1995) Randomised comparison of chiropractic and hospital outpatient management for low back pain: results from extended follow-up. British Medical Journal 311: 349-351.
- Shekelle, P.G., Adams, A.H., et al. (1991) The appropriateness of spinal manipulation for low back pain: project overview and literature review. Santa Monica, California: RAND; Monograph No. R-4025/1 – CCR/FCER.
- Kirkaldy-Willis, W.H. & Cassidy, J.D. (1985) Spinal manipulation in the treatment of low back pain. Can. Fa. Phys. 31: 535-540.
- Bronfort, G. (1997) Efficacy of manual therapies of the spine. Amsterdam: Vrije universiteit EMGO Institute.
- Mooney (1995) J. Musculoskeletal Medicine. Oct: 33-39.
- Drezner & Herring (2001) Managing Low Back Pain. Phys. & Sports Med. 29(8).
- Frank (1993) British Medical Journal. April 3: 901-909.
- McGorry, R.W. (2000) Spine 25: 834-841.