A study found that spinal manipulation could ease back pain. Lower back pain is one of the most common reasons why people go to the doctor and is also a common reason why doctors prescribe powerful and possibly addicting narcotics.
The research, which was published Tuesday in the Journal of the American Medical Association, was conducted to analyze whether the use of spinal manipulative therapy in the management of acute lower back pain was associated with improvements in pain.
Researchers analyzed data from 26 studies that involved over 1,700 patients with lower back pain. The investigation concluded that spinal manipulation could, in fact, reduce lower back pain.
Spinal manipulation therapy can improve pain for patients with lower-back pain
The National Center for Complementary and Integrative Health (NIH) describes spinal manipulation as one of the several options that can provide mild-to-moderate relief from lower back pain. It is typically performed by chiropractors, osteopathic physicians or physical therapists, and it consists of applying pressure and moving joints in the spine of the patient.
According to NIH, back pain affects 8 of 10 people at some point in their lives, and the lower back area is often most affected. The NIH explains that spinal manipulation is relatively safe when performed by a trained and licensed practitioner, and side effects can include feeling tired or temporary soreness.
NIH adds that cauda equina syndrome (CES), which consists of a narrowing of the lower part of the spinal canal that causes nerves becoming pinched and causing, weakness, and loss of feeling in one or both legs, can be an exceedingly rare complication of spinal manipulation therapy. However, it is unclear whether there’s a direct link between CES and spinal manipulation, as CES can still occur without any treatment being performed on a patient.
Patients who received spinal manipulation experienced a decline of 1 point in their pain scale, according to Dr. Paul Shekelle, internist at West Los Angeles Veterans Affairs Medical Center, and lead author of the study.
“So if it had been a 7 it would be a 6, or if it had been a 5 it would be a 4,” said Shekelle, according to NPR.
That pain relief is around the same amount of aid provided from NSAIDs, nonsteroidal anti-inflammatory medication such as ibuprofen.
The study found that spinal manipulation improved function modestly in some patients. Some patients reported greater ease and comfort when receiving the therapy, such as being able to walk faster, and experiencing less discomfort when turning in bed or sleeping.
Spinal manipulation is preferred to prescribing opioids medicines
However, according to Dr. Richard Deyo, a professor at the Oregon Health and Science University, spinal manipulation can reposition the small joints in the spine in a way that causes less pain. Deyo wrote an editorial that was published along with the study.
Deyo adds that spinal manipulation can restore some material in the disks between the vertebrae, or it can directly help relax muscles in the patient, which could be important to ease the pain. He adds that there also may be a mind-body interaction that comes from the laying of hands, which by developing a trusting relationship between patients and health practitioners can improve pain in patients.
Deyo clarifies that other possible treatments for lower back pain include oral medications, corsets, injected drugs, surgery, traction, acupuncture, and massage therapy. However, he believes that out of all possible treatments, no one is superior to spinal manipulation. For Deyo, the most important thing is that people avoid taking medication when experiencing lower back pain.
“Even over-the-counter medications have some important side effects and complications,” said Deyo. “Spinal manipulation seems to be quite safe when it’s done in the lower back.”
NSAIDs can cause gastritis, a rise in blood pressure and an upset stomach. Furthermore, if patients are prescribed stronger medication like opioids, there’s a risk of long term use and addiction.
The study overall found that over 1711 patients provided moderate-quality evidence that spinal manipulation therapy has a statistically significant association with improvements in pain. Over 1381 produced moderate-quality evidence that SMT has a significant association with improvements in functions. The study concludes that among patients with lower back pain, spinal manipulation therapy was associated with improvements in pain and function at up to 6 weeks.
On April 4, the American College of Physicians released a guideline of noninvasive treatments for people with lower back pain. The guidance suggests that individuals who suffer from the condition can use techniques to speed up the healing process, like heat wraps, acupuncture, massage and spinal manipulation. The guideline lines up with the new study conducted, although specialists believe that further investigation on the condition could help doctors to refer patients who can benefit from spinal manipulation to proper therapists.