Is Chronic Low Back Pain Managing You Or Are You In Control? : A Review Of Recent Research
Chiropractic care, recognised for its non-invasive approach, continues to be scrutinised in scientific research to establish effective treatment protocols for chronic conditions, particularly low back pain. Three significant studies have made considerable contributions to our understanding of chiropractic dosage and its effectiveness.
1. Dose-Response for Chiropractic Care of Chronic Low Back Pain (Haas et al., The Spine Journal)
The study conducted by Haas and colleagues focuses on the dose-response relationship in the chiropractic treatment of chronic low back pain. The researchers sought to determine the optimal number of chiropractic visits needed to provide the most significant relief. They found that higher visit frequencies were associated with greater pain relief and functional recovery. This study is pivotal as it suggests that the intensity of treatment (in terms of visit frequency) plays a critical role in enhancing patient outcomes, thereby supporting the need for tailored treatment plans based on individual patient needs.
2. The Nordic Maintenance Care Program (Eklund et al., PLOS ONE)
Eklund and his team investigated the effectiveness of maintenance care provided by chiropractors for patients with recurrent and persistent low back pain. Their randomized controlled trial compared maintenance care with symptom-guided treatment. The findings revealed that maintenance care, where patients receive regular chiropractic treatments regardless of symptom presence, resulted in fewer days with bothersome pain compared to treatments initiated based on patients' symptomatic flare-ups. This study emphasises the potential benefits of preventative chiropractic interventions, highlighting the importance of ongoing care in managing chronic back pain and preventing exacerbations.
3. Manipulation and Mobilization for Treating Chronic Low Back Pain (Coulter et al., The Spine Journal)
Coulter and colleagues provided a comprehensive systematic review and meta-analysis on the effectiveness of spinal manipulation and mobilization. They assessed these methods across various dosages to understand their impact on pain management and functional improvement in chronic low back pain sufferers. Their analysis supports the efficacy of these techniques, with variations in dosage playing a significant role in the outcomes. This research underscores the need for a personalized approach to chiropractic manipulations, tailored to the severity and specifics of the patient's condition.
So what does this mean?
Collectively, these studies shed light on the complex nature of chiropractic care in managing chronic low back pain. They underscore the importance of individualised treatment planning, which considers the frequency, duration, and type of chiropractic interventions. The findings suggest that more frequent and sustained chiropractic sessions can lead to better outcomes in pain reduction and functional improvements.
Furthermore, the notion of maintenance care as a preventive strategy could revolutionise how chronic back pain is managed, suggesting that regular chiropractic care could be more effective than the conventional symptom-driven approach.
Conclusion
These studies collectively advocate for a more structured and evidence-based approach to chiropractic care, with a strong emphasis on personalised treatment dosages. As the field moves towards an evidence-based model, these findings are crucial for informing clinical decisions, optimizing patient outcomes, and integrating chiropractic care more effectively into broader healthcare frameworks.
This comprehensive exploration not only highlights the therapeutic potentials of chiropractic care but also calls for ongoing research to further refine and substantiate these preliminary findings.
Haas, M., Vavrek, D., Peterson, D., Polissar, N., & Neradilek, M. B. (2018). Dose-response for chiropractic care of chronic low back pain. The Spine Journal, 18(9), 1599-1614. doi:10.1016/j.spinee.2018.05.018
Eklund, A., Jensen, I., Lohela-Karlsson, M., Hagberg, J., Leboeuf-Yde, C., Kongsted, A., ... & Axén, I. (2018). The Nordic Maintenance Care Program: Effectiveness of chiropractic maintenance care versus symptom-guided treatment for recurrent and persistent low back pain—A pragmatic randomized controlled trial. PLOS ONE, 13(9), e0203029. doi:10.1371/journal.pone.0203029
Coulter, I. D., Crawford, C., Hurwitz, E. L., Vernon, H., Khorsan, R., Booth, M. S., & Herman, P. M. (2018). Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. The Spine Journal, 18(5), 866-879. doi:10.1016/j.spinee.2018.01.013