The approach a doctor of chiropractic will take to manage low back pain will differ depending if the injury is new (acute), recent (subacute), or has persisted for three months or longer (chronic). Though some management tools overlap between each group, each stage of injury includes unique challenges that require specific interventions.

ACUTE LOW BACK PAIN: In this stage, it’s important to address inflammation and to avoid aggravating the injury, which can hinder recovery. Chiropractic pain management strategies include a multi-modal care approach that can include manual therapies (spinal manipulation, mobilization, stretching, massage, and more), tools to reduce inflammation (ice, topical agents, electric stim, laser), muscle relaxing techniques (dry needling and acupuncture), at-home exercise, and nutrition/diet recommendations (anti-inflammatory diet, turmeric, Boswellia, omega-3 fatty acids, vitamin D3, etc.). Importantly, the patient must be assured that they can get better.

SUBACUTE LOW BACK PAIN: The management strategy and treatment goals at this stage are similar to the acute stage, but the intensity of care may be increased. The patient may also receive instruction on muscle strengthening exercises specific to their case, and they should maintain normal activities as much as possible so that the condition does not become chronic and more challenging.

CHRONIC LOW BACK PAIN:  In the chronic phase, the patient may have changed their movement patterns to avoid pain, which may place adjacent tissues and other areas of the body at risk for injury. They may also be hesitant to return to their previous lifestyle out of fear of making their pain worse, causing them to give up a hobby or even change careers. This can lead to depression and anxiety, which may need to be co-managed with an allied healthcare provider. At this stage, the key is to restore normal joint motion, address faulty mechanics, strengthen muscles that have atrophied, and encourage the patient to resume their normal lifestyle and activities.

Following the conclusion of care, the patient may also find that routine visits to their chiropractor can help them reduce their risk for a future episode.