The Difference in Effectiveness of Medical vs. Chiropractic Treatment in Acute and Chronic Back Pain

Have you ever considered who is the best suited to treat back pain? Since there are so many treatment options available today, it is quite challenging to make this decision without a little help. To facilitate, an October 2005 study published in the Journal of Manipulative and Physiological Therapeutics looked at this very question and compared the effectiveness between medical and chiropractic intervention for patients with back pain. Researchers followed-up 2,780 patients via questionnaires at the start of the study and after two weeks, one month, three months, six months, one year, two years, and four years. Patients were treated using conventional approaches by either Medical Doctors (MDs) or Doctors of Chiropractic (DCs). Treatments from the chiropractors included spinal manipulation, physical therapy, an exercise plan, and self-care education. Medical therapies included prescription drugs, an exercise plan, self-care advice, and about 25% of the patients received physical therapy.

The study focused on present pain severity and functional disability (activity interference) measured by questionnaires that were mailed to the patients at various intervals (see above) during the study. The researchers reported that chiropractic was favored over medical treatment in the following areas:

• Pain relief in the first 12 months (more evident in the chronic patients).
• When low back pain (LBP) radiated below the knee (more evident in the chronic patients).
• Chronic LBP patients with no leg pain (during the first 3 months).

Similar trends favoring chiropractic were seen for disability but were of smaller magnitude. All patient groups saw significant improvement in both pain and disability over the four-year study period. Acute patients saw the greatest degree of improvement with many achieving symptom relief after three months of care. Noteworthy, at the three-year point, ½ to ¾ of all the patients reported at least 30 days of pain during the prior year including those that responded well after early treatment. Also, 19 to 27% of chronic LBP patients noted daily pain during the prior year. This suggests that LBP is more likely to return at times in the future, which many have similarly reported to be true.

However, this study also found that early intervention reduced chronic pain and, and after three years, those acute LBP patients that received early intervention reported fewer days of LBP that those who waited longer for treatment. While both MDs and DCs treatment approaches helped, it’s quite clear from the information reported that chiropractic treatment approaches should be utilized first.

These findings support the importance of early intervention by chiropractic physicians makes the most sense for those of you struggling with the question of whom to see for your LBP.