Chronic low-back pain – what’s the best answer?

What’s the best way to treat low-back pain?  

Not surprisingly, particularly for low-back pain, I’d say chiropractic, but I would wouldn’t I – but so does Haas M, Goldberg B, Aickin M, Ganger B, Attwood M. in their study called:

A practice-based study of patients with acute and chronic low back pain attending primary care and chiropractic physicians: two-week to 48-month follow-up.

Now, this study looked at patients with acute (or short-lived) and chronic back pain.  They compared the standard medical treatment, you know, the ‘take these go away for a couple of weeks” sort of thing, to chiropractic care.  A pretty robust number of patients were examined in the study (2780 patients over a 2-year period).  There were 60 chiropractic doctors involved (treating 1855 of the patients) and 111 medical doctors (treating 925 patients).

The medical doctors treated their patients with a regimen of prescription drugs, an exercise plan and self-care advice with some receiving physical therapy.  The chiropractic doctors treated their patients with a regimen of spinal manipulation, physical therapy, an exercise plan and self-care education.  The success of the treatment was measured by the patient’s report of their degree of pain and/or disability.  The patients were given a pain questionnaire on their first visit which was then followed up with regular questionnaires over a period of 4 years. 

Those patients who were treated by the medical doctors initially had a greater degree of pain and disability, in addition to pain radiating below the knee.  They also had poorer general health than those patients treated by the chiropractors.

Those patients who were treated by the chiropractors saw a modest advantage in their pain relief over those treated by the medical doctors in the first 12 months.  The greatest difference was in those patients who had chronic low-back pain.  There was a noticeable statistical advantage in the chiropractic patients who experienced chronic pain that radiated to below the knee.

The important point in this study is that ALL patient groups saw significant improvement in pain and disability over the course of treatment.  Those patients who were experiencing acute pain saw the greatest improvement, with many of them gaining almost complete relief of their pain symptoms.  However, it was interesting to note that 3 years into this study, up to 75% of the patients had experienced at least 30 days of pain in the previous year – even those who had seen significant pain and disability relief through early intervention.

So what does this mean for low-back pain sufferers?low-back pain

What does this study ultimately prove?  Here are the two key take-aways:

The earlier you can deal with pain, the more effective the treatment when you are experiencing chronic pain.  In the study, those patients who dealt with their pain early on experienced fewer days of back pain than those who had waited.  Overall, their treatments were more successful in reducing their pain.  So, if you are experiencing back pain – don’t delay.  Early intervention can play a huge part in your recovery for the long run.

Chiropractic care can be more beneficial than medical care for certain kinds of pain.  For those patients who had chronic low-back pain and those with pain below the knee chiropractic care was the most effective.  Equally importantly, those patients who visited their chiropractor felt relief within the first 3 months.

Haas M, Goldberg B, Aickin M, Ganger B, Attwood M. A practice-based study of patients with acute and chronic low back pain attending primary care and chiropractic physicians: two-week to 48-month follow-up. Journal of Manipulative and Physiological Therapeutics 2004;27(3):160-169.

Leave a Reply

Your email address will not be published. Required fields are marked *