Just last week, the BMJ – one of the world’s most prestigious medical journals – published that spinal manipulation (synonymous with chiropractic adjustments) works as good as other recommended therapies for lower back pain. What does this mean for you as a pain sufferer?
I am sure chiropractors all around the world are super stoked to have the BMJ endorsing spinal manipulation. (Did they though?) After all, most people associate chiropractors with spinal manipulation. But what does this paper really mean and how does it sit within the context of evidence-based care?
First, the paper acknowledged that spinal manipulation is NOT the first line treatment for chronic low back pain.
Second, at both one month and 12-months, spinal manipulation had no clinical effect for pain when used as an adjunct therapy.
Third, at both one month and 12 months, spinal manipulation was not statistically (or clinically) better than other recommended treatments.
Most important of all, the study only looked at chronic low back pain and the improvement in function is only for the short-term. This means there is no long-term improvement in function!
So , spinal adjustments is useful in short-term improvement in function. It is not a viable treatment option for long-term improvement.
When it comes to pain, spinal manipulation is not useful in both the short and long-term.
What do I do about my lower back pain then?
If we look at the paper discussed in our previous entry, the eleven recommendations that are consistent across musculoskeletal pain conditions recommended for manual therapy to be used as an adjunct treatment.
Doesn’t it make sense now? Despite the latest study on spinal manipulation seeming to support chiropractic adjustments as a viable low back treatment, it really is not. When compared against other recommended treatments or when used as an adjunct, spinal manipulation does not perform well for pain relief. It is at best a temporary solution to increase function.
The best thing you can do for your lower back pain is to seek professional advice from an evidence-based chiropractor. Good chiropractors care for their patients and help them get better as quickly as reasonably possible.
What is the best evidence low back pain treatment then?
Well, the most recent international guidelines by Lancet made four first-line treatment recommendations for chronic low back pain. They are:
1. Advice to remain active
2. Education
3. Exercise therapy
4. Cognitive therapy
What do they say about spinal manipulation? Second-line treatment option or to be used as an adjunct.
So there you go. This is what the BMJ is really saying and it is congruent with other international guidelines. No, the medical journal is not endorsing chiropractic adjustments as a long-term solution for your chronic pain.
This should come as no surprise. Traditional chiropractors are fixated on that spinal misalignment is the cause of your back, neck problem, or shoulder pain. This is is not true. Read more at The Chiropractic Adjustment – Seven Hard Truths You Need To Know
Square One vs. other chiropractors in Singapore
We are the first exercise-based chiropractic clinic in Singapore and we are also the only chiropractor who does not adjust all of our clients. The difference? We offer front-line best evidenced care. We are willing to do what it takes so you can get the best results! We constantly keep ourselves updated with the latest research findings. We have a good understanding of existing literature. We make good, best-evidence clinical decisions so you can go back to doing what you love. Drop us a message to find out how we can help you.