Chiropractic for lower back pain
Your health expert: David Phillips, Chiropractor
Content editor review by Rachael Mayfield-Blake, March 2023
Next review due March 2026
Chiropractic is a healthcare profession that focuses on diagnosing and treating disorders that affect your bones, muscles and joints, such as lower back pain. A healthcare practitioner called a chiropractor mainly uses their hands to apply force to your spine to treat these problems but they may use other techniques too.
About chiropractic
Chiropractors treat a range of health conditions, including neck and back pain. They’re interested in how problems with your bones, muscles and joints affect your nervous system and general health. Chiropractic is often a manual therapy where your practitioner uses skilled hand movements to apply force (manipulate) to your joints and soft tissues. But while their focus is on manipulation of the spine, they may use other techniques instead.
A chiropractor can offer chiropractic treatment for short- or long-term lower back pain. It may also help if you have pain in other parts of your back, such as middle back pain, or have neck pain. They can also help with sciatica, which is pain that spreads from your back down one of your legs.
You can arrange treatment with a chiropractor yourself and book a private appointment. Chiropractic is rarely available on the NHS, but if chiropractic is available in your area, a GP may refer you. For more information, see our section below: Find a chiropractor in your area.
Find 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 a GP may be able to refer you, but this is rare.
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’re registered with the GCC.
You can find a registered chiropractor in your area by visiting the General Chiropractic Council website. Your chiropractor may also display the "I'm Registered" mark in their practice or on their website.
Chiropractic procedure
Finding the problem
Your first appointment with a chiropractor will usually last between 30 minutes and an hour, and follow-up appointments about 10 to 30 minutes. Your chiropractor will talk to you about your back pain and your health in general. If you’re happy for them to, they’ll give you a physical examination, which may include examining your posture and the range of movement of your joints. They may ask you to remove some clothing; if so, they’ll give you a gown to wear.
Informed consent
Your chiropractor will discuss their findings with you and whether or not they think chiropractic will help. If your chiropractor thinks you need other treatment for back pain, they’ll suggest you see a GP or another health professional.
They’ll set out a plan of what treatment they think you’ll need, including how many sessions and what the cost will be. The plan may be for you to have one (or more) treatments a week for a few weeks initially. Your chiropractor may recommend a longer-term treatment plan if you have complex problems or you keep getting back pain because of your job.
Your chiropractor 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 suggesting because they’ll ask you for your consent before they go ahead with treatment.
Chiropractic treatment
The main technique that chiropractors use is called manipulation. This means your chiropractor will use their hands to make precise, controlled movements or thrusts to your spine, which are called adjustments. You may hear popping sounds during the treatment, but this is normal.
Chiropractors sometimes use other techniques, such as massage, stretching and mobilisation, where they gradually move your joints. Some chiropractors may also offer treatment with acupuncture.
Your chiropractor will give you some advice on things you can do yourself to manage your condition. This may include advice on your posture and exercise.
Uses of chiropractic
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 to get back to your normal activities. It’s best to keep active rather than rest as it’s the best thing for back pain.
If you’re offered manual therapies as NHS treatment, your doctor will 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 (one of the chiropractic techniques) have found that it works as well as, but no better than, other treatments for back pain (such as exercise therapy and medical treatment).
Aftercare for 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, ask your chiropractor for advice.
If your symptoms don’t improve 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 to 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.
Side-effects 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.
Complications of chiropractic
Complications or risks of chiropractic treatment, such as spinal manipulation, are extremely rare. Your chiropractor should talk to you about any potential risks before they do any treatment.
Alternatives to chiropractic
There are different types of manual therapy that can treat lower back pain, which all take a slightly different approach. In addition to chiropractic, manual therapies include the following.
- Physiotherapists focus on restoring movement and function to your whole body after you’ve had an 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.
- Osteopaths look at the health of your body as a whole and aim to make sure all your bones, muscles and joints function smoothly together. They focus on manual therapies to get your body back to a state of balance.
Manual therapy can be done in many different ways and varies 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 would like NHS treatment, you’re most likely to be offered physiotherapy because the other services are often not funded. If you’re going to book private treatment, 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 they cover.
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The number of chiropractic sessions you’ll need will depend on your individual circumstances. Your chiropractor should give you an estimate at your first appointment. You may need to have one or more sessions a week for a few weeks to begin with. Or you may need a longer-term treatment plan if you have more severe problems.
See our section: Chiropractic procedure above for more information.
The first appointment you have with a chiropractor will usually last between 30 minutes and an hour. If you have follow-up appointments, they won’t be as long. They’ll be about 10 to 30 minutes.
See our section: Chiropractic procedure above for more information.
You don’t need to avoid anything after chiropractic. But you may want to take it easy as you might have some pain or discomfort for a short time after your treatment. It shouldn’t last long and is nothing to worry about so see how you feel and what you feel you can do.
See our section: Side-effects and complications of chiropractic above for more information.
It’s not known yet if chiropractic adjustment works better than massage. Chiropractors may also use massage as part of their treatment. Both are different types of what’s called manual therapy.
If you find that chiropractic or massage doesn’t help your health problem, your practitioner will suggest you see a GP or another health professional.
How often you need to get an adjustment from a chiropractor will depend on your condition and how you respond to treatment. You may not need to have a spinal adjustment every time you see a chiropractor as they may use a variety of techniques. Your chiropractor should give you an idea how many treatments you need. Most people see an improvement in their condition after a few treatment sessions but if you don’t, you may need a different type of treatment.
See our section: Chiropractic procedure above for more information.
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