Chiropractic for lower back pain

Chiropractic is a healthcare profession that focuses on diagnosing and treating disorders that affect your bones, nerves, muscles, and joints. This includes lower back pain and sciatica. A healthcare practitioner called a chiropractor mainly uses manual therapy or “hands on” therapy. This includes spinal manipulation, which uses hands to apply force to your spine. But they may use other techniques too.

About chiropractic

Chiropractors treat a range of health conditions, including neck and back pain. Their main aim is to reduce pain, and improve your movement and overall health using different techniques. They’re also interested in how problems with your bones, muscles, and joints affect your nervous system and general health.

Chiropractic is often a manual therapy. Your practitioner uses skilled hand movements to apply force to your joints and soft tissues. This is called manipulation of the spine. Sometimes they may use other techniques instead.

A chiropractor can offer chiropractic treatment for short- or long-term lower back pain. They may also help pain in other parts of your back, such as middle back pain, or neck pain. They can also help with sciatica, which is pain that spreads from your back down one of your legs.

You don’t need a GP referral to see a chiropractic. You can arrange treatment with a chiropractor yourself and book a private appointment. Chiropractic is rarely available on the NHS. But you could speak to your GP first to see if they think chiropractic will help you.

Find 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 themselves a chiropractor unless they’re registered with the GCC.

All chiropractors go through at least four years of training before they are qualified and can register with the GCC. Most chiropractors work in the private sector – either alone or in a group practice.

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. Follow-up appointments are usually about 10 to 30 minutes. Your chiropractor will talk to you about your back pain and your health in general. They’ll then give you a physical examination if you’re happy for them to do this. You may be able to wear sportswear for your appointment, or your chiropractor may ask you to remove your clothes and give you a gown to wear.

During the examination, they may check:

• your posture
• how you walk (your gait)
• how well you can move your joints
• joint and muscle tension
• how well your nerves are working

You may also need to have some tests or scans, such as an MRI scan or X-ray.

Informed consent

After the detailed assessment, your chiropractor will be able to discuss the diagnosis of your injury and whether or not they think chiropractic will help. They’ll discuss a treatment plan, including how many sessions you’ll need and how much this will cost. The plan may be for you to have one (or more) treatments a week for a few weeks at first. Your chiropractor may recommend a longer-term treatment plan if you have a complex problem or if you keep getting back pain because of your job.

If your chiropractor doesn’t think chiropractic will help your back pain, they’ll suggest you see a GP or another healthcare professional.

Your chiropractor should also discuss any potential side-effects and risks of chiropractic 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 spinal manipulation . This means your chiropractor will use their hands to make precise, controlled movements, or thrusts to your spine. Spinal or joint manipulation is also called adjustment. You may hear clicking, cracking, or popping sounds during the treatment, but this is normal.

Chiropractors sometimes use other techniques, such as:

• massage
• stretching
• mobilisation
• acupuncture

Your chiropractor may suggest other things you can do yourself to manage your condition. These may include advice on:

• your posture
• targeted exercises
• your diet
• mindfulness
• pain management
• managing your weight

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’re worried about anything, 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. You may need to have some more tests or scans, such as an MRI scan.

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 that 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 used in chiropractic. These aren’t usually serious and only last for a short time. You may feel some pain, stiffness, or discomfort in the area that’s been treated. You may also feel tired afterwards.

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

Other types of manual therapy for lower back pain all take a slightly different approach. But physiotherapists, osteopaths, and chiropractors, often use some of the same techniques.

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. They aim to make sure all your bones, muscles, and joints work together smoothly. They focus on manual therapies to get your body back to a state of balance.

Manual therapy can be done in many different ways. This varies between practitioners and depends on different types of training. 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 aren’t often 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.