Though spinal manipulation (often done by chiropractors) was once considered a fringe medical treatment for back pain, more and more medical doctors include the practice in their patients' treatment plans. And before patients walk into a medical doctor's office, many have already seen a chiropractor.
According to Richard Guyer, MD, a spine surgeon at the Texas Back Institute in Plano, some 60% of patients see a chiropractor before they seek out an orthopedic surgeon. So it's likely you will consider (or someone will suggest) spinal manipulation for your back pain. This straightforward guide will help you understand the treatment, the different kinds of professionals who practice it, and whether it can help you.
Key points in making your decision
Spinal manipulative therapy is adjustment of the spine using twisting, pulling, or pushing movements. These movements can loosen and move the spinal bones and joint structures that may be causing pain. This is the basis of chiropractic treatment, but not only chiropractors are trained to do spinal manipulation.
See a chiropractor, an osteopathic doctor, a physiatrist, or a physical therapist who performs spinal manipulation. Your insurance coverage may be a factor in deciding who to see for treatment.
When deciding about spinal manipulation, consider the following:
Spinal manipulative therapy is based on the theory that your spinal health is central to your overall health. It relies on spinal manipulation, or spinal manual therapy, to increase a joint's range of motion. Different practitioners use different manipulation techniques, ranging from massage and slow pressing or twisting to rapid movement or forceful pressure on the head, shoulder, back, or hips. If you have tight or spasming muscles, your practitioner may first use a technique such as heat, ultrasound, or electrical current to relax your muscles before manipulating the spine. Practitioners who are not medical doctors do not use medicines or surgery to treat conditions.
People who benefit from spinal manipulative therapy usually notice improvement after one visit, and additional manipulation is not needed. At most, 2 to 3 weeks of spinal manipulative therapy is considered to be enough to treat acute low back pain. Although some practitioners encourage long-term spinal manipulation for "maintenance" or "preventive" reasons, this practice has no proven value.
Chiropractors are not your only choice for providing spinal manipulation. Osteopathic doctors (DOs) are fully credentialed doctors whose training includes an emphasis on manual therapy. Some physiatrists and physical therapists also provide spinal manipulation. Health insurance coverage varies for this type of treatment, so it's wise to check—before starting treatment—to find out whether your practitioner of choice is covered.
Spinal manipulative therapy is adjustment of the spine using twisting, pulling, or pushing movements. These movements can loosen and move the spinal bones and joint structures that may be causing pain. This is the basis of chiropractic treatment, but not only chiropractors are trained to do spinal manipulation.
See a chiropractor, an osteopathic doctor, a physiatrist, or a physical therapist who performs spinal manipulation. Your insurance coverage may be a factor in deciding who to see for treatment.
When deciding about spinal manipulation, consider the following:
- You may need only home treatment, such as ice, moist heat, pain relievers, and mild exercise. For most people, these home treatments usually relieve low back pain within 4 to 6 weeks.
- Before you try spinal manipulation, have your symptoms evaluated. Certain symptoms, such as sharp pain, or low back pain with leg pain or numbness, can be a sign of a serious condition that needs immediate medical treatment or that could be made worse by spinal manipulation.
- You can't count on spinal manipulation alone to treat low back pain. Good spinal manipulative therapy includes self-care information and strength and conditioning exercises that help your muscles better support your troubled joints.
- If you choose spinal manipulation, find a practitioner who is willing to coordinate care with your other health professionals.
Spinal manipulative therapy is based on the theory that your spinal health is central to your overall health. It relies on spinal manipulation, or spinal manual therapy, to increase a joint's range of motion. Different practitioners use different manipulation techniques, ranging from massage and slow pressing or twisting to rapid movement or forceful pressure on the head, shoulder, back, or hips. If you have tight or spasming muscles, your practitioner may first use a technique such as heat, ultrasound, or electrical current to relax your muscles before manipulating the spine. Practitioners who are not medical doctors do not use medicines or surgery to treat conditions.
People who benefit from spinal manipulative therapy usually notice improvement after one visit, and additional manipulation is not needed. At most, 2 to 3 weeks of spinal manipulative therapy is considered to be enough to treat acute low back pain. Although some practitioners encourage long-term spinal manipulation for "maintenance" or "preventive" reasons, this practice has no proven value.
Chiropractors are not your only choice for providing spinal manipulation. Osteopathic doctors (DOs) are fully credentialed doctors whose training includes an emphasis on manual therapy. Some physiatrists and physical therapists also provide spinal manipulation. Health insurance coverage varies for this type of treatment, so it's wise to check—before starting treatment—to find out whether your practitioner of choice is covered.
Last Updated: February 6, 2008 
