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Chiropractic for lower back pain
Expert reviewer, David Phillips, Chiropractor
Next review due October 2023
Chiropractic is a healthcare profession focusing on diagnosing and treating disorders that affect your bones, muscles and joints. Chiropractors mainly focus on manipulation of the spine, but they may use other techniques too.
Chiropractors have a special interest in problems causing neck, back and joint pain.
Why would I see a chiropractor for back pain?
If you have lower back pain that’s causing significant problems or isn’t getting better, it could be worth trying manual therapy. Manual therapy is a treatment where your practitioner uses skilled hand movements to manipulate and move your joints and soft tissues.
A chiropractor can offer this type of treatment for short- or long-term general lower back pain. They can also help with sciatica – pain that spreads from your back down your legs. Most people arrange treatment with a chiropractor themselves, by booking a private appointment. Chiropractic is rarely available on the NHS, but if it is available in your area, your GP may refer you. For more information on this, see our section: Finding a chiropractor below.
Physiotherapist, osteopath or chiropractor?
If you’re seeking manual therapy for lower back pain, you may be wondering whether you should see a physiotherapist, a chiropractor or an osteopath. These are all health professionals who can treat back pain with manual therapies, but their approach to treatment is slightly different.
- Physiotherapists focus on restoring movement and function to your whole body after you’ve been affected by illness or injury. They look at how the nerves, muscles and bones in your body are affected, and how treatment with exercise therapy and manual therapies can help. They’ll encourage you to take an active part in your rehabilitation, rather than relying on passive treatments.
- Osteopaths look at the health of your body as a whole and aim to make sure all your bones, muscles and joints are functioning smoothly together. They focus on manual therapies to get your body back to a state of balance.
- Chiropractors have a special interest in neck and back pain. Like osteopaths, they also look at your body as a whole. They’re interested in how problems with your bones, muscles and joints affect your nervous system and general health. Their focus is on manipulation of the spine – but they may use other techniques too.
Manual therapy can be carried out in many different ways. These vary according to different types of training and also between individual practitioners. It’s not known yet if one way of doing manual therapy works better than another.
It’s your choice which type of practitioner you see. But if you’re seeking NHS treatment, you’re most likely to be offered physiotherapy because the other services are often not funded. If you’re booking treatment privately, it can be worth contacting a few different practitioners to discuss your circumstances. If you have health insurance, contact your insurance provider to see what you may be covered for.
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How healthy are you?What happens when you see a chiropractor for back pain?
Finding the problem
Your first appointment with a chiropractor will usually last between 30 minutes and one hour. Your chiropractor will want to talk to you about your back pain and your health in general. If you’re happy for them to, they’ll then carry out a physical examination which may include examining your posture and the range of movement of your joints. You may be asked to remove some clothing; if so, you’ll be given a gown to wear.
Your chiropractor may advise you to have further tests such as an X-ray or MRI scan if they think it will help to make a diagnosis. Doctors don’t usually recommend these tests for lower back pain. They should only be used in certain circumstances. Ask your chiropractor to explain why they think these tests are necessary for you and how they’ll be arranged.
If your chiropractor thinks you need other treatment for your back pain, they’ll suggest you see your GP or another health professional.
Informed consent
Your chiropractor will discuss their findings with you and whether or not they think chiropractic will help. They’ll set out a plan of what treatment they think you’ll need, including how many sessions and what the cost will be. They should also discuss any potential side-effects and risks of treatment with you. If you’re unsure about anything, don’t be afraid to ask. It’s important that you fully understand what your chiropractor is proposing because they’ll ask you to sign a consent form before going ahead with treatment.
Chiropractic treatment
The main technique that chiropractors use is called manipulation. It involves your chiropractor using their hands to make precise, controlled movements or thrusts to your spine. You may hear popping sounds during the treatment, but this is normal.
Chiropractors may sometimes use other techniques including massage, stretching and mobilisation (where your joints are gradually moved). Although there’s limited evidence about how well it works for back pain, some chiropractors may also offer treatment with acupuncture.
Your chiropractor will also usually give you some advice on things you can do yourself to manage your condition. This may include advice on your posture and exercise.
What to expect after chiropractic
You may have some pain or discomfort for a short time after your treatment. This shouldn’t last for long and is usually nothing to worry about. If you have any concerns, contact your chiropractor for advice.
Your chiropractor should tell you at your first visit how many sessions you’re likely to need. The plan may be for you to have one or two treatments a week for a few weeks initially. Your chiropractor may recommend a longer-term treatment plan if you have complex problems or your job means you keep getting back pain.
If your symptoms don’t feel any better after a few sessions of treatment, your chiropractor may reassess you. They may discuss other care options for you or suggest you see a different healthcare professional.
Manual therapies such as those offered by a chiropractor are usually only one part of your treatment for back pain. It’s important that you also follow any advice your chiropractor or other healthcare professional may give you on looking after your back and on things you can do to keep active. This will help you to get better faster.
How can chiropractic help me?
The manual techniques used in chiropractic may help to relieve pain and improve how your back works. The aim is for you to get moving again and start getting back to your normal activities. Keeping active, rather than resting is the best thing for back pain.
If you’re offered manual therapies, doctors recommend that you have them as part of a treatment package. This should include a general exercise programme and, if needed, other treatments such as psychological therapy.
Studies on manipulation have found that it works as well as other treatments (such as exercise therapy and medical treatment) for back pain.
Side-effects and complications of chiropractic
You may get some side-effects from manipulation (the main technique used in chiropractic). These usually aren’t serious and only last for a short time. For instance, you may feel some pain, stiffness or discomfort in the area in which you received the treatment.
Your chiropractor will ask you about your medical history. This is so that they’re aware of any medical conditions you have which might increase your risk of side-effects from treatment.
Serious complications following spinal manipulation are extremely rare. Although these are very unlikely to affect you, your chiropractor should talk to you about any potential risks before they carry out any treatment.
Finding a chiropractor
Most chiropractors work in the private sector either alone or in group practices. In some areas, chiropractic may be available on the NHS and your GP may be able to refer you, but this is rare. You don’t need to tell your GP if you’re booking a private appointment with a chiropractor, but it may be best to ask their advice first.
All chiropractors in the UK must be registered with the General Chiropractic Council (GCC). This means they have completed approved standards of training and follow the GCC standards of practice and conduct. It’s against the law for anyone to call themselves a chiropractor unless they are registered with the GCC.
You can find a registered chiropractor by visiting the General Chiropractic Council website. Your chiropractor may also display the ‘GCC registered’ logo in their practice or on their website.
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Related information
Osteopathy for lower back pain
Osteopathy is a system of diagnosing and treating medical conditions that focuses on the structure and functioning of your whole body.
Physiotherapy for lower back pain
If you have back pain, physiotherapy can help to reduce it and get you back to normal mobility.
Psychological support for lower back pain
Treatments that combine both physical and psychological techniques can help you learn how to manage your back pain.
Medicines and pain relief for lower back pain
The pain relief your doctor may offer will depend on what’s causing your pain, how severe it is and whether a medicine is suitable for you.
Epidural injections for lower back and leg pain
Epidural injections into your spine can sometimes provide short-term relief from pain in your lower back and legs, which is known as radicular pain.
Facet joint injections and medial branch blocks
Facet joint injections can help to diagnose and sometimes to treat neck and back pain that originates in your facet joints.
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Other helpful websites
- General Chiropractic Council
www.gcc-uk.org - British Chiropractic Association
chiropractic-uk.co.uk
- General Chiropractic Council
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Sources
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- Complementary and alternative medicine. Patient. patient.info, last edited February 2016
- Low back pain and sciatica in over 16s: assessment and management. National Institute for Health and Care Excellence (NICE), updated September 2020. www.nice.org.uk
- Rubinstein SM, van Middelkoop M, Assendelft WJJ, et al. Spinal manipulative therapy for chronic low-back pain. Cochrane Database of Systematic Reviews 2011, Issue 2. doi:10.1002/14651858.CD008112.pub2
- Low back pain. Brukner & Khan’s Clinical Sports Medicine (5th ed, online). McGraw-Hill Medical. csm.mhmedical.com, published 2017
- About chiropractic. General Chiropractic Council. gcc-uk.org, accessed September 2020
- Seeing a Chiropractor for the first time. General Chiropractic Council. gcc-uk.org, accessed September 2020
- Back pain. British Chiropractic Association. chiropractic-uk.co.uk, accessed September 2020
- Visiting a chiropractor. British Chiropractic Association. chiropractic-uk.co.uk, accessed September 2020
- Health: Chiropractic. Advertising Standards Authority (ASA). www.asa.org.uk, published 3 November 2017
- Chiropractic. NHS. www.nhs.uk, last reviewed September 2020
- What is physiotherapy? Chartered Society of Physiotherapy. www.csp.org.uk, last reviewed 14 March 2018
- About osteopathy. General Osteopathic Council. osteopathy.org.uk, accessed September 2020
- Treatment of sports injuries. Manual treatments. Brukner & Khan’s Clinical Sports Medicine, (5th ed, online). McGraw-Hill Medical. csm.mhmedical.com, published 2017
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Author information
Reviewed by Dr Kristina Routh, Freelance Health Editor, Bupa Health Content Team, October 2020
Expert reviewer, David Phillips, Chiropractor
Next review due October 2023
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