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 Researchers studied 750 active-duty U.S. military service members
being treated for lower back pain. All of them received usual care
like physical therapy and drugs to ease pain and inflammation. In
addition, half of them received chiropractic care that could include
spinal manipulation, rehabilitation exercises and treatment with
cold or heat.
After six weeks, patients receiving chiropractic care reported
larger reductions in low back pain and less related disability than
people who didn't get these treatments, the study found.
"Spinal manipulation (often referred to Hias chiropractic
adjustment) may help heal tissues in your body that form as a result
of injury, decreasing pain and improving your body's ability to move
correctly," said lead study author Dr. Christine Goertz, who did the
research while affiliated with the Palmer College of Chiropractic in
Davenport, Iowa.
"It is also possible that manipulation impacts the way that your
body perceives pain through either the brain or the spinal cord
and/or decreases pain from muscle strain, inflammation and/or spasm
in the muscles next to your spine," Goertz said by email.
Lower back pain is a leading cause of disability and doctor visits
for adults worldwide. It often goes away within a few weeks. But
when it persists, lower back pain might be treated with spinal
manipulation, medications like painkillers or muscle relaxers, heat,
exercise or physical therapy.
It's estimated that one in five U.S. adults have lower back pain.
Direct costs of treatment and indirect costs like lost productivity
exceeded $234 billion in 2010, researchers note in JAMA Network
Open.
Amid a worsening opioid addiction crisis in the U.S., doctors are
increasingly looking for less addictive medications and alternative
treatments for lower back pain, they add.
Chiropractic care in the study included spinal manipulation to help
restore proper alignment in the lower back and surrounding areas.
Participants assigned to chiropractic care received an average of
two to five treatments, depending on their treatment facility.
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After six weeks, people who received chiropractic care reported
average levels of pain intensity that were about 1.1 points lower on
a pain scale of 1 to 10 than individuals who didn't have the
chiropractic treatments. This difference persisted, but was less
pronounced, after 12 weeks.
Of 43 instances of side effects reported by people receiving
chiropractic care, most cases were described as joint or muscle
stiffness. Some people reported these side effects when they weren't
getting chiropractic care, and in this group three people had drug
side effects and four had side effects from epidural injections.
One limitation of the study is that back pain is difficult to
diagnose and confirm, and outcomes of treatment reported by patients
are hard to verify, the authors note. It's also possible that
results from predominantly male and young service members might not
reflect what would happen in the broader population of people with
back pain.
Even so, the results add to evidence suggesting that offering
chiropractic care in addition to other back pain treatments can
improve outcomes, said Daniel Cherkin of the Kaiser Permanente
Washington Health Research Institute in Seattle.
Chiropractic care, like other forms of alternative treatments such
as massage, acupuncture and yoga, has been found to reduce pain and
improve function for people with low back pain, Cherkin, author of
an accompanying editorial, said by email.
"All of these treatments have lower risks of harms than medications,
injections and surgery," Cherkin said. "Because it has not been
possible to predict which patients will benefit most from a specific
treatment, trying several of these alternative treatments to find
one that works is a sensible strategy."
SOURCE: https://bit.ly/2wNTTse and https://bit.ly/2k8PEOE JAMA
Network Open, online May 18, 2018.
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