Spinal Manipulation Can Ease Your Aching Back
A new analysis finds that the hands-on technique works as well as pain drugs and is safer, too
When you wrench your back, your first impulse may be to rummage through the medicine cabinet for an over-the-counter pain drug or even ask your doctor to prescribe a strong opioid painkiller such as Percocet or Vicodin.
But an analysis published April 11 in the Journal of the American Medical Association finds that spinal manipulation can ease your backache and get you moving again without the risk of medication side effects.
A new Consumer Reports survey of more than 3,500 back-pain sufferers reached similar conclusions: Nearly 90 percent of people who tried spinal manipulation found it helpful.
Spinal manipulation involves a healthcare provider applying controlled forces to the spine to improve alignment and allow the muscles and joints to move more easily. While it’s usually done by a chiropractor, some doctors of osteopathic medicine (D.O.) and physical therapists also use the technique.
For the JAMA analysis, researchers from the Department of Veterans Affairs and elsewhere combined results from 26 studies involving more than 3,000 patients with low-back pain lasting six weeks or less. Patients treated with spinal manipulation were able to move through daily activities with less pain than people who didn’t get the therapy.
On average, people treated with spinal manipulation said that their pain improved about 10 points on a 100-point scale.
The Strength of a Nondrug Approach
Recent guidelines from the American College of Physicians recommend trying spinal manipulation or other nondrug measures such as acupuncture and massage before turning to OTC pain medications such as ibuprofen (Advil, Motrin IB, and generic) or naproxen (Aleve and generic). They also strongly discourage the use of prescription opioid painkillers because of the risk of addiction and overdose.
“The real strength of spinal manipulation is that it is equally effective to other forms of commonly used treatments, and it’s safer,” says Paul Dougherty, D.C., chief of chiropractic care at the Canandaigua Veterans Affairs Medical Center in Canandaigua, N.Y., and a co-author of the JAMA review.
None of the studies included in the JAMA analysis reported that spinal manipulation had serious adverse effects. Minor side effects included headaches, soreness, and muscle stiffness, but those were generally short-lived.
“It’s common for people having spinal manipulation for low-back pain to have some soreness, similar to what you might have after a session of exercise,” Dougherty says.
Pain medications, on the other hand, carry more serious risks. Opioids commonly cause nausea, vomiting, and constipation, and make you feel drowsy and “fuzzy-headed.” And a recent study by the Centers for Disease Control and Prevention found that taking an opioid painkiller for more than a few days sharply increases the risk of getting hooked on the drug.
OTC anti-inflammatory drugs are safer than opioids for most people but—especially when taken long term—they can cause serious harm, including kidney problems, bleeding in the stomach or elsewhere in the digestive tract, and an increased risk of heart attack or stroke.
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