Adding chiropractic care to back pain can reduce disability



(Reuters Health) – Adding chiropractic care to standard medical care for low back pain can help reduce discomfort and disability, suggests a US study. UU

Investigators studied 750 US service members on active duty who were being treated for low back pain. All of them received usual care, such as physiotherapy and medications to relieve 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 who received chiropractic care reported larger reductions in lower back pain and less related disability than people who did not receive these treatments, the study found.

"Spinal manipulation (often referred to as chiropractic adjustment of Hias) can help heal the tissues of your body that are formed as a result of injury, decreasing pain and improving the body's ability to move properly", said the study's lead author, Dr. Christine Goertz. who did the research while affiliated with Palmer College of Chiropractic in Davenport, Iowa.

"It is also possible that manipulation affects the way the body perceives pain through the brain or spinal cord and / or decreases the pain from muscle tension, inflammation and / or spasm in the muscles adjacent to the spine, "said Goertz said by email

Back pain is a leading cause of disability and doctor visits for adults around the world. It often disappears in a few weeks. But when it persists, back pain can be treated with spinal manipulation, medications such as badgesics or muscle relaxants, heat, exercise or physical therapy.

It is estimated that one in five adults in the United States have lower back pain. Direct treatment costs and indirect costs, such as lost productivity, exceeded $ 234 billion in 2010, researchers at JAMA Network Open point out.

Amid a worsening crisis of opiate addiction in the US, doctors are increasingly looking for less addictive medications and alternative treatments for low 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 badigned to chiropractic care received an average of two to five treatments, depending on their treatment center.

After six weeks, people who received chiropractic care reported average levels of pain intensity that were approximately 1.1 points lower on a pain scale of 1 to 10 than people who did not receive chiropractic treatments. This difference persisted, but was less pronounced, after 12 weeks.

Of 43 cases of side effects reported by people receiving chiropractic care, the majority of cases were described as joint or muscle stiffness. Some people reported these side effects when they did not receive chiropractic care, and in this group three people had medication 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 the results of treatment reported by patients are difficult to verify, the authors note. It is also possible that the results of predominantly male and young service members do not reflect what would happen to the broader population of people with back pain.

Even so, the results add to evidence suggesting that offering chiropractic care in addition to other treatments for back pain 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 mbadage, acupuncture and yoga, reduces pain and improves the function of people with low back pain, said Cherkin, author of an accompanying editorial, by mail electronic.

"All these treatments have lower risks of harm than medications, injections and surgery," Cherkin said. "Because it has not been possible to predict which patients will benefit more from a specific treatment, testing several of these alternative treatments to find one that works is a sensible strategy."

SOURCE: bit.ly/2wNTTse and bit.ly / 2k8PEOE JAMA Network Open, online May 18, 2018.

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