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Chiropractic for lower back pain
Expert reviewer, David Phillips, Chiropractor
Next review due August 2021
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 and back pain. They look at the effect these problems have on your nervous system as well as your health in general.
Why would I see a chiropractor for back pain?
If you have lower back pain that’s causing significant problems or doesn’t seem to be improving, it could be worth trying manual therapy. A chiropractor can offer this type of treatment for any type of 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 in your area, your GP may refer you. See Finding a therapist, for more information.
Physiotherapist, osteopath or chiropractor?
Physiotherapists, chiropractors and osteopaths 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 specialist 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.
It’s your choice which type of practitioner you see. However, if you’re seeking NHS treatment, you will most likely be offered physiotherapy because the other services are often not funded. If you’re booking treatment privately, think about what you’re hoping to get out of therapy and which approach appeals to you the most. It can be worth contacting a few different practitioners to discuss your own 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 will then carry out a thorough physical examination to assess how your bones, muscles, joints and nerves are working. 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 a blood test, X-ray or MRI scan if they think it will help to make a diagnosis. They’ll talk to you about why they think these tests are necessary and how you can arrange them.
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 you’ll be asked to sign a consent form to go ahead with treatment.
Chiropractic treatment
The main technique that chiropractors use is called manipulation. It involves your chiropractor using their hands to make short, sharp, controlled movements or thrusts to your spine. You may hear popping sounds during the treatment, but it’s not thought to be harmful. The 'pop' is simply the sound of bubbles of gas popping in the fluid of the joint as the pressure is released.
Chiropractors may sometimes use other techniques including massage, stretching and mobilisation (where your joints are gradually moved). Although there’s limited evidence about how effective it is, 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. They’ll review your progress regularly.
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 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 can help to relieve pain and improve how your back works. These effects can last long enough 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. It can mean you get back to work faster, you’re less likely to have long-term problems, and you’re less likely to get back pain again.
Medical guidelines for lower back pain recommend that if you’re offered manual therapies, 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 looking into how well manipulation works have found that it’s just as good as other treatments for back pain. These include exercise therapy and medical treatment.
Side-effects and complications of chiropractic
Manipulation, the main technique used in chiropractic, can be associated with side-effects. 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.
Serious complications following spinal manipulation are extremely rare but injuries such as a fractured rib and damage to nerves in the spine have been reported. 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.
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 themself a chiropractor unless they are registered with the GCC.
You can find a registered chiropractor by checking the General Chiropractic Council register. 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.
Radiofrequency denervation
Radiofrequency denervation (also called facet rhizolysis or radiofrequency ablation) is a procedure to help treat back or neck pain that comes from your facet joints.
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Other helpful websites
- General Chiropractic Council
www.gcc-uk.org - British Chiropractic Association
www.chiropractic-uk.co.uk
- General Chiropractic Council
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Sources
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- About osteopathy. General Osteopathic Council. www.osteopathy.org.uk, accessed 23 May 201.
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- 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
- Treatment of sports injuries. 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 Pippa Coulter, Freelance Health Editor, August 2018
Expert reviewer, David Phillips, Chiropractor
Next review due August 2021
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