Chiropractic or physiotherapy for low back pain?

What to choose? Chiropractic or physiotherapy for back pain?

Being a chiropractor, one would think that the article could be biased and that I will say Chiropractic… But as always, I prefer to base myself on published scientific studies than on personal opinions. There are already studies that have compared Chiropractic care to physiotherapy care or medication for back pain and that I quote on the page ”  treat lumbar pain, lumbago and lumbago “. In most of these comparative studies, it was concluded that chiropractic care can be as effective or more effective than the traditional approach. But there are also studies which have shown that the Chiropractic AND physiotherapy approach is more effective than the chiropractic approach alone which is more effective than the physiotherapy approach alone.

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Personally, it often happens to me to see patients who come to see me having tried drugs, physiotherapy, infiltrations,… for their low back pain, without convincing results. And as much as I think that drugs and infiltrations have no long-term effect (and there are many studies that confirm this), I also think that physiotherapy can help to strengthen and maintain the results obtained in Chiropractic. I think it is indeed difficult to achieve results in physiotherapy if there are blockages and irritations in the spine and the muscles are not responding normally. But once the corrective work is done in Chiropractic,

Comparative study between Chiropractic and Physiotherapy

But today I am telling you about a study released this year, the objective of which was to compare from a cost / effectiveness point of view chiropractic care and physiotherapy care. First of all it should be understood that this study, like many other studies on this subject, was carried out in the United States where the cost of care is an element of access to care for the patient. Several studies have shown that physiotherapy gives better results than medical treatment or no treatment at all for low back pain ( Flor 1992 , Gatchel 2003 , Fritz 2017). Other studies have also shown that chiropractic care is more effective, safer and less expensive than the medical approach (drugs, surgery, etc.) for the treatment of lumbar back pain ( Manga 1993 , Carey 1995 , Goertz 2013 , Hurwitz 2002 ).

This study by the Texas Department of Public Health Policy and Management and published in the journal Healthcare therefore examined the cost-effectiveness of each approach to the treatment of lumbar back pain. The results showed that the total average cost in the Chiropractic care group was slightly lower than that in the Physiotherapy care group. The results also showed that the disability-corrected life expectancy (DALY) in the chiropractic group was slightly higher than in the physiotherapy group. Disability-adjusted life expectancy is an increasingly used measure in public health for the assessment of health care systems.

The conclusions of the study are therefore that chiropractic care is more cost-effective than physiotherapy for adults with at least three weeks of low back pain over six months.

To see a chiropractor or a physiotherapist?

As I said above I think both may be necessary: ​​first see a chiropractor to correct joint blockages and nerve imbalances that prevent muscles from working normally and once these issues are corrected see a physiotherapist to strengthen the muscles and allow the person to better maintain the corrections made.

References :

Khodakarami N. Treatment of Patients with Low Back Pain: A Comparison of Physical Therapy and Chiropractic Manipulation. Healthcare (Basel). 2020;8(1):44. Published 2020 Feb 24.