Pain medication is a common and convenient treatment for lower back pain.

See Early Treatments for Lower Back Pain

But easier is not always better, as a recent study suggests that spinal manipulation may provide more relief than at least one popular pain medication.

See Understanding Spinal Manipulation

Spinal manipulation may also be used to treat neck pain and migraines. Read more about Spinal Manipulation: High-Velocity Low-Amplitude (HVLA)

Published in the journal Spine, the recent study suggests that treating acute, non-specific lower back pain with spinal manipulation therapy is more effective than treatment with the non-steroidal anti- inflammatory drug diclofenac.1

See Common NSAIDs for Back and Neck Pain

The design of the study

A number of patients with acute lower back pain (<48 hours) entered the study. They were randomly assigned to 1 of 3 groups:

  • Spinal manipulation group. These patients received standardized spinal manipulation (high-velocity low-amplitude thrust) and placebo diclofenac.
  • Diclofenac group. These patients received 50 mg diclofenac three 3 per day along with sham manipulation.
  • Placebo group. These patients received sham manipulation and placebo diclofenac.

See Non-Surgical Treatments for Lower Back Pain


Results point to spinal manipulation

Data was collected to measure the following:

  • Self-rated disability
  • Functioning
  • Time off work
  • Number of times a rescue medication (a medication not part of the study) was taken due to intense pain

The main findings of the study are two-fold:

  • Both spinal manipulation and diclofenac were more effective than the placebo. In fact, the researchers closed the placebo portion of the study early due to the intense pain levels reported by people in the placebo group.
  • The results indicated that the people in the spinal manipulation group experienced a superior quality of life (lower scores of self-reported disability and lower levels of pain) than those in the diclofenac group.

What does this mean for you?

Simply put, it may be easier and less time consuming to take pain medicine to help with your lower back pain; but spinal manipulation may be more effective.

The 2 most-common types of spinal manipulation include:

  • High-velocity low-amplitude thrust. This manipulation is often associated with an audible "pop," as it involves chiropractors applying controlled and sudden force to a joint while your body is positioned in a specific way. This is the type of manipulation used for the study.
  • See Spinal Manipulation: High-Velocity Low-Amplitude (HVLA)

  • Low-force or gentle chiropractic techniques. Some patients find mild mobilization techniques, that do not involve twisting of the body or a forceful thrust, to be preferable.
  • See Spinal Mobilization: Gentle Chiropractic Techniques

But it is important to remember that no one treatment works for everyone. Instead, finding relief from your lower back pain is often a process of trial and error.

Therefore, make sure to speak with your medical professional to discuss all of your lower back pain treatment options.

Learn more:

How To Select The Best Chiropractor

Medications for Back Pain and Neck Pain


  • 1.Spine (Phila Pa 1976). 2013 Apr 1;38(7):540-8. doi: 10.1097/BRS.0b013e318275d09c.