What to Do for Chronic Low Back Pain

Low back pain (LBP) is a very common problem that many, if not most of us, have had at some point in life. In fact, about 80% of adults experience LBP in their lifetime, and it’s the leading cause of job-related disability and missed work days. According to the National Institutes of Health, more than 25% of adults have had a recent episode of LBP.

Men and women are equally affected by LBP, which can occur abruptly following a specific incident (such as over lifting), or it can develop slowly over time due to wear and tear. Studies show a sedentary lifestyle during the week can set the stage for developing LBP, especially when it’s followed by strenuous weekend workouts.

Although about 80% of acute LBP (lasting a few days to weeks) resolves with self-care or short-term management, about 20% of those with acute LBP will still have persistent symptoms after a year. So what can be done to manage chronic LBP and prevent disability?

One study looked specifically at maintenance spinal manipulative therapy (SMT) to determine its effectiveness in managing chronic LBP, which they defined as LBP that persists for more than six months. Researchers randomly assigned sixty patients to receive either 1) 12 treatments of sham SMT for one month; 2) 12 treatments of SMT for one month but no treatment thereafter; or 3) 12 treatments for one month followed by SMT twice a month for the following nine months.

The research team found that groups two and three experienced significantly lower pain and disability scores than the sham treatment group at the end of the first month. However, only the third group experienced more improvement in regards to pain and disability at the ten-month evaluation. In the absence of continued SMT, the second group’s pain and disability scores returned back to near pre-treatment scores. The authors concluded that SMT is effective for chronic nonspecific LBP, but to obtain long-term benefit, patients should continue to receive care on an ongoing basis.