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Patient Handout: Chiropractic Care for Low Back Pain

Evidence Based Decision Making:

Effective Chiropractic Care For: Low Back Pain


This information will help you understand your choices, making you a more informed patient on the benefits of chiropractic care.  It is our mission to provide you with the most reliable and trustworthy source of Chiropractic Health Information, which is based upon strong supportive evidence backed by research.

Key Points in your Decision about choosing Chiropractic Care?

Chiropractic is a non-invasive, drug-free, results-oriented form of treatment that exposes the patient to less risk than medical approaches that traditionally favor medications and surgery.

ü      Does your condition have a proper diagnosis?

ü      Does your condition have no known cause or cure?

ü      Is your condition acute or chronic?

ü      Does your condition adversely affect your functional status?

ü      Have you been taking medications for your conditions?

ü      Does your medications have any side effects?

ü      Is surgery an option?

ü      Have you ever tried any form of Complementary or Alternative Medicine in the relief of your symptoms?




These are important questions in which a Chiropractor is fully trained to help you answer.   Chiropractors are trained in the diagnosis and treatment of disease with particular emphasis on neuromusculoskeletal conditions.  If necessary, Chiropractors will refer out for most appropriate tests or referral to medical specialist in order for you to receive the best care possible.




When deciding about chiropractic care, consider the following:

q       Emphasis on patient recuperative abilities rather than drugs or surgery

q       The structure and condition of the body influences how the body functions and its ability to heal itself

q       The mind-body relationship is instrumental in maintaining health and in the healing processes.

q       Recognition that dynamics exist between lifestyle, environment and health

q       Recognition of the centrality of the nervous system and its intimate relationship with the capacities of the human body

q       Balancing benefits versus risks of clinical interventions

q       Recognition of the primary importance of monitoring progress closely through appropriate diagnostic procedures

q       A patient-centered, hands-on approach focused on influencing function through structure




Is Chiropractic Care Effective for the Treatment of Low Back Pain?

Chiropractic care has been shown to be an effective treatment option for low back pain, an almost universal epidemic in which 80% of the adult population will encounter.   Over 40 randomized clinical trials have been published comparing spinal manipulation/adjustment with other treatments for low back pain.   The better-quality clinical trials have indicated that spinal manipulation/adjustment is superior to other types of intervention (corsets, massage, mobilization, back education, physiotherapy, acupuncture) and at least as effective as non-steroidal anti-inflammatory agents (NSAID’s) 1-10 - but without the side effects of NSAID’s which have been shown to affect no fewer than seven organ systems (gastrointestinal, liver, renal, hematologic, central nervous, skin, and respiratory).

Furthermore, clinical practice guidelines on low back pain release in December 1994 by the Agency for Healthcare Policy and Research (AHCPR) rank spinal manipulation/adjustment in the top tier of clinical options available for the treatment of low back pain alongside the use of non-steroidal anti-inflammatory agents.11

Therefore, evidence suggests chiropractic intervention is the most effective (and simultaneous drugless) intervention for cases of low back pain.

 What is the Chiropractic Treatment protocol for Low Back Pain?

 What is the Chiropractic Treatment protocol for Low Back Pain?

Low back pain is always seen in the context of the spine as a whole; in addition to addressing the lower back, the chiropractor addresses possible spinal joint restrictions in the neck, mid-back, and extremities that may need correction.   Manual adjusting techniques can be used successfully in the neck and mid-back, while the low back is addressed with low force techniques, the most notable being the “flexion-distraction” technique applied in a series of treatments combined with adjunctive physiotherapy, supplementation, and eventual introduction of home exercises for low back conditions.12

Personal Comments for better decision-making:

Personal Comments for better decision-making:

Use the following space to list any other important questions or concerns you may have about treating low back pain with Chiropractic Care.

Evidence Based Decision Making

After reading this article, you should have a better idea of how you feel about using Chiropractic Treatment for low back pain.  Informed patients make better health decisions.








  1. Koes BW, Bouter LM, DV An Mameren H, Essers AHM, Verstegen GM Jr, Hofhuizen DM, Houben JP, Knipschild PG, The effectiveness of manual therapy, physiotherapy, and treatment by the general practitioner for nonspecific neck and back complaints: A randomized clinical trial. Spine 1992; 17(1): 28-35.

  2. Meade TW, Dyer S, Browne W, Townsend J, Frank AO.  Low back pain of mechanical origin:  Randomized comparison of chiropractic and hospital outpatient treatment.  British Medical Journal 1990; 300: 1431-1437

  3. Meade TW, Dyer S, Browne W, Townsend J, Frank AO. Randomized comparison of chiropractic and hospital outpatient management for low back pain: Results from extended follow-up.  British Medical Journal 1995; 311: 349-351.

  4. Triano J, McGregor M, Hondras MA, Brennan PC. Manipulative therapy versus education programs in chronic low back pain. Spine 1995; 20(8): 948-955.

  5. Giles LGF, Muller R. Chronic spinal pain syndromes: A clinical pilot trial comparing acupuncture, a non-steroidal anti-inflammatory drug, and spinal manipulation.  Journal of Manipulative and Physiological Therapeutics 1999; 22(6): 376-381.

  6. Bronfort G, Goldsmith C, Nelson CF, Boline PD, Anderson AV. Trunk exercise combined with spinal manipulative or NSAID therapy for chronic low back pain: A randomized, observer-blinded clinical trial. Journal of Manipulative and Physiological Therapeutics 1996; (19) 9:570-582.

  7. Kirkaldy-Willis WH, Cassidy JD. Spinal manipulation in the treatment of low back pain. Canadian Family Physician 1985; 31: 535-540.

  8. Pope MH, Phillips RB, Haugh LD et al. A prospective randomized three-week trial of spinal manipulation, transcutaneous muscle stimulation, massage and corset in the treatment of subacute low back pain. Spine 1994; 19(22): 2571-2577.

  9. Blomberg S, Varsudd K, Mildenberger F: A controlled multicenter trial of manual therapy in low back pain: Initial status, sick leave and pain score during follow-up. Journal of Orthopedic Medicine 1994; 16(1): 2-8.

  10. Berquist-Ullman M, Larsson U. Acute low back pain in industry: A controlled prospective study with special reference to therapy and confounding factors.  Acta Orthopedica Scandinavia 1977; 170:1-117.

  11. Bigos S, Bowyer O, Braen G, et al. Acute Low Back Pain in Adults. Clinical practice guidelines No.14. AHCPR Publication NO.95-0642, Rockville, MD: Agency for Healthcare policy and Research, Public Health Service, U.S. Department of Health and Human Services. December 1994.

Strasser, Arn D.C. Chiropractic Care and Back Pain: Techniques:  Part 3 of 3: Chiropractic Care and Back Pain: Non-Invasive Treatment for Bulging, Ruptured, or Herniated (Slipped Discs) published on, Article written 07/28/2003 Published online 08/13/2003, last updated 08/11/2004







Authors:          Joseph A. Rotella BS, DC, MD

 Michael R. Scoma BS, MD




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Posted On 2/1/2006