The question remains: should a person suffering from acute low back pain seek standard medical care from a general practitioner in addition to chiropractic manipulation from a chiropractor?
Until recently, there had been no clear consensus on whether standard medical care alone, or standard medical care in conjunction with chiropractic manipulation works best to relieve low back pain. To help answer this question, researchers recently studied active-duty military men and women (ages 18-35) suffering from acute low back pain. The study group had all been experiencing pain for four weeks or less.
The study enrolled a total of 91 patients. One randomly selected group of 46 patients received standard medical care alone.
Standard Care Group:
The Standard care group received any or all of the following:
- Focused history and physical examination
- Diagnostic imaging as indicated
- Education about self-management, including maintaining activity levels as tolerated
- Pharmacological management with the use of analgesics and anti-inflammatory agents
- Physical therapy and modalities, such as heat/ice
- Pain clinic referral
The remaining 45 patients received a combination of standard medical care plus chiropractic manipulation.
Combination Care Group:
The Combination Care Group Received:
- Same standard medical care outlined above from a medical doctor
- High-velocity low-amplitude (HVLA) manipulative therapy from a chiropractor
- Complementary treatments as needed: brief massage, stretching instruction, McKenzie exercises
Investigators measured the results of the two different treatment regiments using the Roland-Morris Disability Questionnaire (RMQ), which rates physical functioning, and the numerical rating scale (NRS), which measures self- reported pain on a scale from 1-11.
Study results indicate that at the end of four weeks:
- Reported pain and disability decreased significantly in both groups.
- Reported pain and disability decreased significantly more in the combination (standard medical care plus chiropractic manipulative therapy) group than in the standard medical care only group.
The results of this study suggest that a combination of both standard medical care and chiropractic manipulation may be a more effective choice for relief of acute lower back pain than standard medical care alone.
An interesting future study would compare a combination of standard medical care plus chiropractic manipulation to chiropractic manipulation therapy alone.
Goertz CM, Long CR, Hondras MA, Petri R, Delgado R, Lawrence DJ, Owens EF, Meeker W (2013) Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: results of a pragmatic randomized comparative effectiveness study. Spine (Phila Pa 1976) 2013 Apr 15;38(8):627-34C.