Lower back pain is one of the most common conditions amongst the population of the UK – for that matter, it is one of the most common health complaints worldwide! As a Chiropractor, we see more patients for lower back pain than any other single condition, so we can certainly attest to the effectiveness of chiropractic care in resolving and preventing lower back pain (just check out our reviews!) Unfortunately, some medical professionals and a portion of the general public still have questions about the effectiveness of chiropractic care for lower back pain – this week, let’s take a look at the most recent research on this issue.
Recent studies on lower back pain
Both the medical and chiropractic professions acknowledge that lower back pain is a major global problem – and it’s one which is getting worse[1]. A recent series of articles in the prestigious journal the Lancet, authored by world leading authorities on low back pain, has drawn international attention to how enormous the problem is. The Lancet authors also discussed how low back pain is being poorly managed by healthcare systems around the globe, including emerging issues in low and middle-income countries. A recent article from the journal of Chiropractic and manual therapies has summarised some of the most important findings[2]. Let’s look at some of the results:
Lower back pain has many causes, and the cause can be hard to identify
One large scale review article[3] looked at the complexity of low back pain and the factors that contribute to it. One of the most challenging aspects of dealing with lower back pain is the wide variety of causes which can contribute to it – and the research confirms this. The article pointed to various factors known to cause or aggravate back pain, such as psychological, social, and biophysical factors, comorbidities (conditions which exist together), and pain-processing mechanisms.
The article went further than some and argued that for the vast majority of people with low back pain it is currently not possible to accurately identify the specific source of pain.
Thankfully, chiropractic care takes a whole-body approach to better health – which is perhaps one of the reasons for its success in treating lower back pain. Simply put, since a chiropractor is interested in treating any issue you have (rather than just focusing on lower back pain) any aggravating factors, or hidden causes will often also be addressed.
More research on prevention is required, and there’s more chiropractors can do
The next study of interest highlighted the lack of research into effective prevention of lower back pain, as well as the fact that many patients are not receiving an appropriate treatment once they have experienced lower back pain[4]. It was demonstrated that many patients receive inappropriate imaging (x-rays), and treatments that are not helpful, or even harmful, such as rest, opioids, spinal injections, and surgery.
While it is clear form this research that chiropractic care is an excellent alternative to many of the ineffective methods which some patients receive, there were also some messages which chiropractors need to take on board. Specifically, the research suggested that some chiropractors order too many x-rays, continue with the initial level of treatment for too long and sometimes provide treatments which are not supported by evidence.[5]
Since Complete Chiropractic is a Chiropractic Biophysics clinic, our entire methodology is grounded in the latest, evidence-based treatment, so these are factors we consider as central to patient care. The chiropractic biophysics approach puts great emphasis on tailoring and adapting treatment based on the patients immediate and ongoing needs. While this means all of our approaches are evidence based, our treatment plans are also adaptive for the needs of a client. While a typical treatment plan starts out with several visits a week, treatment frequency at our clinic is gradually tapered down to an appropriate level for maintenance.
Since we are also able to provide X-Rays on site, we are able to take only the minimum number required. Many chiropractors send their patients to another clinic for X-rays, which often means ordering more than might be required to ensure all bases are covered.
Government needs to do more
The final article considered here was a review of the current situation of back pain treatment as it concerns public policy. This study argued that low back pain needs to be prioritised, together with other musculoskeletal conditions, as a public health problem, particularly in low and middle-income countries. Amongst other issues, the study highlighted some problems including political challenges, such as increasing the recognition of the effects and costs of back pain by policy makers as well as healthcare challenges, such as changing culture and changing clinician behaviour. They urged organisations such as the World Health Organisation to take action in an attempt to reduce increasing and costly effects of disabling low back pain.
This attitude is certainly one which we support as a clinic – we see all too clearly the effect that back pain and the associated disability can have on the workforce and more importantly on families. It’s because of the disruption that a back problem can cause that many of our clients maintain their regular care as a preventative method. Chiropractic care can be especially valuable to anyone involved in manual work too –in fact, many of our clients are involved in physical work – pop into the clinic and you’ll see tradesman, warehouse operatives and landscape gardeners!
Chiropractors are ideally positioned to assist with lower back pain
The chiropractic profession is perfectly placed to be a major player in providing a part of the solution to the global challenge of low back pain – but it’s important that we continue to expand our research and improve our services to make our approaches even more effective. Staying on top of the latest research is an important part of this process, so when you’re looking for a chiropractor be sure to check that they are up to date! Looking for a Chiropractic Biophysics practice is a great way to do this.
[1] Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380(9859):2163–96.
[2] Simon D. French et al. Low back pain: a major global problem for which the chiropractic profession needs to take more care. Chiropractic & Manual Therapies 2018 26:28
[3] Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356–67.
[4] Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross DP, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018;391(10137):2368–83.
[5] Simon D. French et al. Low back pain: a major global problem for which the chiropractic profession needs to take more care. Chiropractic & Manual Therapies 2018 26:28
