Turning to your chiropractor for a spinal manipulation procedure, also known as a chiropractic adjustment, can help alleviate mild-to-moderate lower back pain, researchers confirm.

The study, featured April 11 in the Journal of the American Medical Association, was based on an analysis of multiple clinical trials involving the use of spinal manipulation in the management of lower back pain.

The scientists combed through four different databases looking at biomedical data from 2011 to 2017 and reviewed 26 clinical studies that compared chiropractic treatment with other alternatives or placebo.

Results showed the procedure can improve pain intensity by an average one point on a scale from 1 to 10, as reported by study participants.

"Spinal manipulative therapy was associated with statistically significant benefits in both pain and function, of on average modest magnitude, at up to six weeks," state study authors in their paper.

They researchers also note that more than half the patients in the larger-scale studies experienced minor adverse events after undergoing chiropractic adjustments for pain management. These were only temporary and included increased pain, muscle stiffness, and headache.

How Spinal Manipulation Works

It's not clear exactly how spinal manipulation relieves back pain.

The procedure, performed by chiropractors, physical therapists, osteopaths, and massage therapists, is done by applying pressure and repositioning small joints in the spine.

Dr. Richard Deyo, an internist and professor at the Oregon Health and Science University, believes moving the joints allows them to realign in a way that is less painful.

Another explanation could be that the procedure relaxes the muscles and restores some material in the disk between the vertebrae.

In addition to easing pain, the study found chiropractic adjustments helped treated patients walk more easily, have less difficulty turning over in bed, and sleep better.

Safer Alternative To Painkillers

Lower back pain is among the top afflictions for which doctors commonly prescribe addictive opioid analgesics.

The confirmation that chiropractic treatment could offer a somewhat effective alternative is good news for non-acute pain sufferers.

According to 2008 Chochrane review analyzed in the study, the pain-relief effect of spinal manipulation is comparable to that of nonsteroidal anti-inflammatory medication, such as ibuprofen.

This means patients can safely turn to the procedure to avoid the side effects and complications of over-the-counter painkillers, which range from stomach problems and gastritis to hypertension.

"Spinal manipulation is one of those therapies that on average has a small effect, and it's in your doctor's bag of things you can pull out and try," said Dr. Paul Shekelle, lead study author and physician at the VA Medical Center in West Los Angeles.

The American College of Physicians (ACP) also recommends alternative therapies for lower back pain in detriment of analgesic drugs. ACP guidelines, released earlier this year, suggest patients try heat wraps, massage, acupuncture, and spinal manipulation.

"For the treatment of chronic low back pain, physicians should select therapies that have the fewest harms and costs," states Nitin S. Damle, ACP president.

"Physicians should avoid prescribing unnecessary tests and costly and potentially harmful drugs, especially narcotics, for these patients."

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