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Chiropractic Care and Back Pain

(continued)

What do chiropractors do in treating patients? continued...

When the chiropractor treats you, he may perform one or more adjustments. An adjustment (also called a manipulation treatment) is a manual therapy, or therapy delivered by the hands. Given mainly to the spine, chiropractic adjustments involve applying a controlled, sudden force to a joint. They are done to increase the range and quality of motion in the area being treated. Other health care professionals--including physical therapists, sports medicine doctors, orthopedists, physical medicine specialists, doctors of osteopathic medicine, doctors of naturopathic medicine, and massage therapists--perform various types of manipulation. In the United States, chiropractors perform over 90 percent of manipulative treatments.16

Most chiropractors use other treatments in addition to adjustment, such as mobilization, massage, and nonmanual treatments (see examples in the box).1

Examples of Nonmanual Chiropractic Treatments1

  • Heat and ice
  • Ultrasound
  • Electrical stimulation
  • Rehabilitative exercise
  • Magnetic therapy
  • Counseling about diet, weight loss, and other lifestyle factors
  • Dietary supplements
  • Homeopathy
  • Acupuncture

To find out more about magnetic therapy, homeopathy, acupuncture, and other CAM therapies, contact the NCCAM Clearinghouse (see "For More Information").

Have side effects or problems been reported from using chiropractic to treat back pain?

Patients may or may not experience side effects from chiropractic treatment. Effects may include temporary discomfort in parts of the body that were treated, headache, or tiredness. These effects tend to be minor and to resolve within 1 to 2 days.7,17

The rate of serious complications from chiropractic has been debated. There have been no organized prospective studies on the number of serious complications. From what is now known, the risk appears to be very low.14,16,17 It appears to be higher for cervical-spine, or neck, manipulation (e.g., cases of stroke have been reported18,19).The rare complication of concern from low-back adjustment is cauda equina syndrome, estimated to occur once per millions of treatments (the number of millions varies; one study placed it at 100 million16).1,20,a

For your safety, it is important to inform all of your health care providers about any care or treatments that you are using or considering, including chiropractic. This is to help ensure a coordinated course of care (to find out more, see the NCCAM fact sheet "Selecting a Complementary and Alternative Medicine Practitioner").

aMore information on the topic of complications can be found in references 1-3, 14, 21, and 22, and in scientific databases such as CAM on PubMed (see "For More Information").

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