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Search Health Information    Low Back Pain: Should I Have Spinal Manipulation?

Low Back Pain: Should I Have Spinal Manipulation?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Low Back Pain: Should I Have Spinal Manipulation?

Get the facts

Your options

  • Have spinal manipulation for your low back pain.
  • Don't have spinal manipulation.

If your symptoms are very bad or are getting worse, or if you're getting new symptoms, be sure to tell your doctor.

Key points to remember

  • 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 by staying active and doing exercises that help your muscles better support your joints. Good self care will help your back stay strong and help you feel better.
FAQs

What is spinal manipulation?

Spinal manipulation, also called spinal adjustment, is a therapy that uses pressure on a joint of the spine. It 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.

Spinal manipulation can also be used with other treatments, such as medications, exercise, and physical therapy.

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

How well does spinal manipulation work for low back pain?

Spinal manipulation can work as well as other treatments for low back pain that is new or back pain that has lasted a long time. Like most low back pain treatments, spinal manipulation works for some people but not for others. 1

How do you choose someone to do spinal manipulation?

Whenever you are looking for a health care provider who is trained to do spinal manipulation, ask friends about who they do and don't like, and why. Check the background and education of providers you're interested in. It is sometimes helpful to have a visit to make sure you are comfortable with a provider's practice style.

Make your family doctor aware of your other providers and the treatments you are getting.

What are the risks of spinal manipulation?

Spinal manipulation is safe when performed by a trained health care provider. Some people feel tired or sore after treatment.

A very rare but serious nerve problem, which can cause weakness or a bladder or bowel problem, may be related to spinal manipulation. But some experts question whether it is related.

Why might you consider spinal manipulation?

  • You want a treatment that involves hands-on contact.
  • You have tried home treatments for a few weeks, and your back pain is not better.
  • You want a treatment that does not involve medicines.
  • You have had spinal manipulation before, and it has helped.

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Have spinal manipulation Have spinal manipulation
  • You lie on a special table while the practitioner puts pressure on a joint of the spine. 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.
  • Spinal manipulation is done to relieve pain and help the body function better.
  • Some people get pain relief from spinal manipulation.
  • Some people feel sore or tired after spinal manipulation.
  • Although it is very rare, spinal manipulation may result in a severe pinched nerve that can affect the bladder or bowel.
Use other treatment Use other treatment
  • You can apply ice or heat to your back, find a comfortable position when you rest, and exercise regularly.
  • You can take pain medicine.
  • For most people, home treatments relieve low back pain within 4 to 6 weeks.
  • Some people keep having back pain even with home treatment.
  • Some people look for non-medicine back pain treatments because of side effects from medicines, such as nausea or an upset stomach.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about spinal manipulation for low back pain

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I grew up in a family that swears by spinal manipulation. When I moved out on my own in another city, I went to the chiropractor down the street from me when I hurt my back. I didn't feel comfortable. This guy had a totally different approach than my old chiropractor. After asking various friends, I found another chiropractor I felt more comfortable with.

Tara, age 24

I've put up with bouts of this back pain over the years, but this time I couldn't walk right. After a couple of days, a friend of mine suggested I see his osteopathic doctor to have my spine worked on. I didn't know much about spinal manipulation, but I thought I'd give it a try. And you know, after three visits, my pain got a lot better.

Joe, age 40

I'm pretty careful about who I choose for my medical care. So I did some research before going to see someone about treating my back pain. I'd heard about some people who actually felt worse after spinal manipulation. I'd also heard from friends that manipulation helped them a lot. So I talked to my doctor and got the name of a chiropractor. I talked to her on the phone ahead of time about how she practices. She sounded great. After I made sure that she was covered by my health insurance, I took the first appointment that was available. A few appointments and daily exercises at home have brought me such relief!

Sandra, age 37

I went to a physical therapist who has helped me with my back with spinal manipulation before. But this time my symptoms were different and he was concerned. I had pain and weakness in my leg that was getting worse. My physical therapist worked with my family doctor and I was referred to a neurosurgeon. I eventually needed surgery.

Dave, age 55

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to choose spinal manipulation

Reasons not to choose spinal manipulation

I am comfortable with treatment that involves hands-on contact.

I don't like the idea of treatments that involve physical contact.

More important
Equally important
More important

I want to avoid using medication for my pain.

Medication or another treatment will help relieve my pain.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Trying spinal manipulation

NOT trying spinal manipulation

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1.

Do most people with low back pain get better with good home treatment?

  • Yes That's right. For most people, home treatments—such as ice, moist heat, pain relievers, and mild exercise—relieve low back pain within 4 to 6 weeks.
  • No No, this is not correct. For most people, home treatments—such as ice, moist heat, pain relievers, and mild exercise—relieve low back pain within 4 to 6 weeks.
  • I'm not sure It may help to go back and read "Compare Your Options." Research shows that for most people, home treatments—such as ice, moist heat, pain relievers, and mild exercise—relieve low back pain within 4 to 6 weeks.
2.

Is spinal manipulation a back pain treatment that works for everyone?

  • Yes Sorry, that's wrong. As with all treatments for back pain, this treatment works for some people but not others.
  • No Correct. As with all treatments for back pain, this treatment works for some people but not others.
  • I'm not sure It may help to go back and read "Get the Facts." As with all treatments for back pain, this treatment doesn't work for everyone.

Decide what's next

1.

Do you understand the options available to you?

2.

Are you clear about which benefits and side effects matter most to you?

3.

Do you have enough support and advice from others to make a choice?

Certainty

1.

How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
3.

Use the following space to list questions, concerns, and next steps.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision  

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts  

Key concepts that you understood

Key concepts that may need review

Getting ready to act  

Patient choices

Credits and References

Credits
Credits Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer Robert B. Keller, MD - Orthopedics

References
Citations
  1. Chou R, Huffman LH (2007). Nonpharmacologic therapies for acute and chronic low back pain: A review of the evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline. Annals of Internal Medicine, 147(7): 492–504.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Low Back Pain: Should I Have Spinal Manipulation?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the facts

Your options

  • Have spinal manipulation for your low back pain.
  • Don't have spinal manipulation.

If your symptoms are very bad or are getting worse, or if you're getting new symptoms, be sure to tell your doctor.

Key points to remember

  • 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 by staying active and doing exercises that help your muscles better support your joints. Good self care will help your back stay strong and help you feel better.
FAQs

What is spinal manipulation?

Spinal manipulation, also called spinal adjustment, is a therapy that uses pressure on a joint of the spine. It 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.

Spinal manipulation can also be used with other treatments, such as medications, exercise, and physical therapy.

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

How well does spinal manipulation work for low back pain?

Spinal manipulation can work as well as other treatments for low back pain that is new or back pain that has lasted a long time. Like most low back pain treatments, spinal manipulation works for some people but not for others. 1

How do you choose someone to do spinal manipulation?

Whenever you are looking for a health care provider who is trained to do spinal manipulation, ask friends about who they do and don't like, and why. Check the background and education of providers you're interested in. It is sometimes helpful to have a visit to make sure you are comfortable with a provider's practice style.

Make your family doctor aware of your other providers and the treatments you are getting.

What are the risks of spinal manipulation?

Spinal manipulation is safe when performed by a trained health care provider. Some people feel tired or sore after treatment.

A very rare but serious nerve problem, which can cause weakness or a bladder or bowel problem, may be related to spinal manipulation. But some experts question whether it is related.

Why might you consider spinal manipulation?

  • You want a treatment that involves hands-on contact.
  • You have tried home treatments for a few weeks, and your back pain is not better.
  • You want a treatment that does not involve medicines.
  • You have had spinal manipulation before, and it has helped.

2. Compare your options

  Have spinal manipulation Use other treatment
What is usually involved?
  • You lie on a special table while the practitioner puts pressure on a joint of the spine. 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.
  • You can apply ice or heat to your back, find a comfortable position when you rest, and exercise regularly.
  • You can take pain medicine.
What are the benefits?
  • Spinal manipulation is done to relieve pain and help the body function better.
  • Some people get pain relief from spinal manipulation.
  • For most people, home treatments relieve low back pain within 4 to 6 weeks.
What are the risks and side effects?
  • Some people feel sore or tired after spinal manipulation.
  • Although it is very rare, spinal manipulation may result in a severe pinched nerve that can affect the bladder or bowel.
  • Some people keep having back pain even with home treatment.
  • Some people look for non-medicine back pain treatments because of side effects from medicines, such as nausea or an upset stomach.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about spinal manipulation for low back pain

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I grew up in a family that swears by spinal manipulation. When I moved out on my own in another city, I went to the chiropractor down the street from me when I hurt my back. I didn't feel comfortable. This guy had a totally different approach than my old chiropractor. After asking various friends, I found another chiropractor I felt more comfortable with."

— Tara, age 24

"I've put up with bouts of this back pain over the years, but this time I couldn't walk right. After a couple of days, a friend of mine suggested I see his osteopathic doctor to have my spine worked on. I didn't know much about spinal manipulation, but I thought I'd give it a try. And you know, after three visits, my pain got a lot better."

— Joe, age 40

"I'm pretty careful about who I choose for my medical care. So I did some research before going to see someone about treating my back pain. I'd heard about some people who actually felt worse after spinal manipulation. I'd also heard from friends that manipulation helped them a lot. So I talked to my doctor and got the name of a chiropractor. I talked to her on the phone ahead of time about how she practices. She sounded great. After I made sure that she was covered by my health insurance, I took the first appointment that was available. A few appointments and daily exercises at home have brought me such relief!"

— Sandra, age 37

"I went to a physical therapist who has helped me with my back with spinal manipulation before. But this time my symptoms were different and he was concerned. I had pain and weakness in my leg that was getting worse. My physical therapist worked with my family doctor and I was referred to a neurosurgeon. I eventually needed surgery."

— Dave, age 55

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to choose spinal manipulation

Reasons not to choose spinal manipulation

I am comfortable with treatment that involves hands-on contact.

I don't like the idea of treatments that involve physical contact.

More important
Equally important
More important

I want to avoid using medication for my pain.

Medication or another treatment will help relieve my pain.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Trying spinal manipulation

NOT trying spinal manipulation

Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Do most people with low back pain get better with good home treatment?

  • Yes
  • No
  • I'm not sure
That's right. For most people, home treatments—such as ice, moist heat, pain relievers, and mild exercise—relieve low back pain within 4 to 6 weeks.

2. Is spinal manipulation a back pain treatment that works for everyone?

  • Yes
  • No
  • I'm not sure
Correct. As with all treatments for back pain, this treatment works for some people but not others.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

Credits
By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer Robert B. Keller, MD - Orthopedics

References
Citations
  1. Chou R, Huffman LH (2007). Nonpharmacologic therapies for acute and chronic low back pain: A review of the evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline. Annals of Internal Medicine, 147(7): 492–504.

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