Low back pain impacts every facet of daily life. From the moment you put your feet on the floor in the morning until you tuck them into the covers at night, your low back is working hard to support your body throughout the day. Pain in this region of the body can be debilitating, physically, mentally, and emotionally. Instead of reaching automatically for prescription medications or surgeries that may not work, many doctors and patients are instead looking for less invasive options. Spinal manipulation for low back pain is one of those treatments.

What is spinal manipulation?

Spinal manipulation is exactly what it sounds like. Applying focused pressure and force to the spine in very specific ways, a doctor of chiropractic (and sometimes a trained osteopathic doctor) manipulates the spine, bringing the vertebrae into better alignment. There are over 100 specific, named techniques to accomplish this.

Most doctors will focus on just eight to ten of these, usually falling in one of two categories:

  • High velocity thrust: This is the traditional approach to chiropractic. Manipulations using these techniques often result in an audible popping noise as gas is released from between the joints. The hands are applied to the joint in a specific way, thrusting quickly in a controlled manner to manipulate the joint.
  • Low-force thrusts: Patients may prefer this gentler approach to chiropractic. Some health conditions such as osteoporosis also make this a safer option. Less force and twisting are used as the doctor gently moves the joints back to alignment.

Chiropractors may also use special equipment to perform certain spinal manipulations. The flexion-distraction technique is designed to separate the lumbar, thoracic, and cervical regions of the spine using gently applied controlled force in combination with a table with a drop leaf. This technique is used to restore range of motion and mobility in the spine.

The activator technique uses a special tool that is gentle even for older patients who are at risk for spinal fracture due to osteoporosis. Young children who have difficulty sitting still for longer adjustment techniques may also benefit from this technique. Activator helps address joint dysfunction that may be indicated by unequal length in the legs.

Research on spinal adjustment

One of the benefits of chiropractic is that side effects are virtually non-existent. Patients may feel some soreness in the area of adjustment in the day following the adjustment, but other than that spinal manipulations are generally very safe. The one serious potential side effect is vertebrobasilar stroke, but recent studies on over one million older patients showed that the risk is so small as to be hard to connect directly to the spinal manipulation itself.

As spinal manipulation gains popularity as a low-risk treatment for low back pain, researchers have begun to look more closely at its efficacy in treating pain that is both acute and chronic. Studies have been generally small, but solid research is emerging on spinal manipulation’s effectiveness against low back pain, both chronic and acute.

  • A person who seeks chiropractic treatment after an injury to the lumbar (low back) region of the spine before seeking treatment with an allopathic doctor is much less likely to have spinal surgery.
  • In a study published in The Spine Journal, researchers reviewed 699 studies of spinal manipulation treatments as compared to other types of treatments that included exercise, medication, mobilization, and sham (placebo) treatments. Researchers found that five to ten sessions of spinal manipulation therapy over two to four weeks was just as effective as other treatments, if not more, in the majority of studies. Unlike other treatments in the studies, there were no side effects reported for spinal manipulation.
  • A large-scale consumer survey carried out by Consumer Reports found that chiropractic care outperformed all other treatments for back pain. This includes outperforming traditional prescription medications in managing pain.
  • Researchers from the University of Florida found that patients who received spinal manipulation experienced less pain as a direct result of their treatment. Study participants with low back pain were assigned to one of four groups: SMT, placebo SMT, enhanced placebo SMT (when patients were told they would be receiving either SMT or a placebo), or no treatment. Participants reported on their pain, including any changes in pain sensation during the session. Enhanced placebo SMT was the most effective treatment, and researchers believe these results are directly related to the care itself.

Finding a chiropractor 

As with any type of medical care that is outside your traditional range of care, talk with your doctor before beginning chiropractic treatments. He or she may be able to recommend a qualified doctor of chiropractic. You can also find chiropractors near you on our website or seek recommendations from trusted friends or family members. In general, if more than one person recommends a particular doctor, chances are good that they may be a good option. A qualified chiropractor will also be happy to schedule an over-the-phone or in-person consultation before treatment to answer any questions you may have.

At your first appointment, the doctor will take a detailed medical history, including your health in general and any specific injuries or conditions that brings you to chiropractic. Additional X-rays or an MRI may be advised before beginning treatment, especially if there are any indications of a more serious condition. After the health history and any additional tests are run, the doctor will perform an appropriate series of spinal manipulations. While the first appointment may take a little longer because of the health history and potential X-rays, subsequent visits may only last from 15 to 45 minutes. If you do not have a reduction in pain after four or five visits, or the pain increases, spinal manipulation may not be a good treatment for you.

For more information on spinal manipulation and chiropractic care, visit the American Chiropractic Association website today!

Image by Michael Dorausch via Flickr


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