Deciding about spinal manipulation for low back pain: Overview

What is spinal manipulation?

Spinal manipulation is a treatment that uses pressure on a joint of the spine. It is also called spinal adjustment. This treatment is used to improve pain and function.

Manipulation can be done with the hands or a special device. The careful, controlled force used on the joint can range from gentle to strong, and from slow to rapid. Sometimes other joints of the body are also worked on to help treat the spine.

Health care providers who are commonly trained to do spinal manipulation include:

• Chiropractic doctors.
• Osteopathic doctors.
• Physiotherapists.
• Medical doctors, such as physiatrists.

What are key points about this decision?

• Spinal manipulation is done to relieve pain and help the body function better. Like most low back pain treatments, it works for some people but not for others.
• Spinal manipulation generally works well to help low back pain. It is safe when performed by a trained health care provider.
• All treatments for low back pain have possible side effects. After spinal manipulation, some people feel tired or sore. Serious problems are very rare.
• Most people with new low back pain get better with good home treatment like ice, staying active, and doing certain exercises. In 4 to 6 weeks, most people feel better.
• No matter what back pain treatment you choose, learn how to take care of your back. Stay active and do exercises that help your muscles better support your joints. Good self-care will help your back stay strong and help you feel better.

Why might you choose spinal manipulation?

• You want a treatment that involves hands-on contact.
• You have tried home treatment for a few weeks, and your pain isn't better.
• Many people get pain relief from spinal manipulation.
• You want a treatment that does not involve medicines.

Why might you choose not to have spinal manipulation?

• You aren't comfortable with hands-on contact.
• Most new low back pain improves with time. You want to wait and see if your pain gets better with good home care. Home care includes ice, staying active, and doing certain exercises.
• Like other back pain treatments, spinal manipulation works for some people, but not for others.
• Even though serious side effects are very rare, you still worry that they could happen to you.

Your decision

Thinking about the facts and your feelings can help you make a decision that is right for you. Be sure you understand the benefits and risks of your options, and think about what else you need to do before you make the decision.