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Treating Lower-Back with Spinal Manipulation

Evidence indicates that spinal manipulation, the application of controlled force to a joint, can provide mild-to-moderate relief from lower-back pain. It appears to be as effective as conventional treatments, and recent guidelines for health care practitioners include it as a treatment option for pain that does not improve with self-care.

Spinal manipulation is generally a safe treatment for lower-back pain. Again, it is the application of controlled force to a joint, moving it beyond the normal range of motion in an effort to aid in restoring health. The most common side effects (e.g., discomfort in the treated area) are minor and go away within 1-2 days.

In the United States, spinal manipulation is often performed as part of chiropractic care. Chiropractic care is a whole medical system that focuses on the relationship between the body’s structure, mainly the spine, and function. Practitioners perform adjustments (also called manipulation) with the goal of correcting structural alignment problems to assist the body in healing. Back problems are the most common reason people seek chiropractic care.

In 2007 guidelines, the American College of Physicians and the American Pain Society include spinal manipulation as one of several treatment options for practitioners to consider using when pain does not improve with self-care. Recent studies have found that spinal manipulation provides relief from lower-back pain at least over the short term and that pain-relieving effects may continue for up to 1 year. In one study funded by the National Center for Complementary and Alternative Medicine (NCCAM) that examines long-term effect in more than 600 people with lower-back pain, results to date suggest that chiropractic care involving spinal manipulation is at least as effective as conventional medical care for up to 18 months. However, less than 20 percent of participants in this study were pain free at 18 months, regardless of the type of treatment used.

Reviews have concluded that spinal manipulation is relatively safe when performed by a trained and licensed practitioner. The most common side effects, discomfort in the area treated, headache, and tiredness, are generally minor and temporary. The rate of serious complications from spinal manipulation, although not definitely known, appears to be very low overall.