Treating Low Back Pain with Chiropractic Care: Efficacy and Evidence

Low back pain (LBP) is a pervasive health issue and a leading cause of disability worldwide. Despite numerous nonpharmacologic treatments available for LBP, including chiropractic care, primary care providers (PCPs) often rely on pharmacologic interventions.

This article examines the feasibility and efficacy of implementing chiropractic care in primary care settings, particularly in underserved communities.

Adoption of Chiropractic Care for Low Back Pain

Roseen et al. (2025) conducted a stepped-wedge cluster randomized controlled pilot trial to increase the adoption of chiropractic care for low back pain (LBP) in three primary care clinics. The implementation strategy involved educational materials, local chiropractor networks, and modifications to electronic health records (EHR) to facilitate referrals.

The study observed a rise in chiropractic care referrals and a reduction in the use of pain medications, indicating better adherence to LBP treatment guidelines.

Chiropractic Care and Its Approach

Chiropractic care focuses on diagnosing and managing musculoskeletal disorders through manual adjustments and other non-pharmacological methods. This approach aims to enhance mobility, reduce pain, and improve overall function.

It offers:

Viable Treatment Option

A Cochrane Review (2011) highlighted the benefits of SMT, showing that it provides a modest but significant improvement in pain and functional outcomes for individuals with chronic low-back pain.

Such findings reinforce the role of chiropractic care as a viable treatment option in primary care settings (Rubinstein et al., 2011).

Reducing Reliance on Pharmaceuticals

Chiropractic care is associated with reduced reliance on pharmaceuticals, particularly opioids, which aligns with current healthcare priorities to mitigate the opioid crisis.

Better Pain Relief

A study published in JAMA Network Open (2018) evaluated the effects of adding chiropractic care to usual medical treatment among military personnel with LBP. The study concluded that incorporating chiropractic care led to better pain relief and functional improvement, highlighting its potential to enhance traditional treatment approaches without additional pharmacological interventions (Goertz et al., 2018).

Patient Satisfaction

Patient satisfaction is another critical factor contributing to the increased adoption of chiropractic care for LBP. Many patients appreciate the personalized, hands-on nature of chiropractic treatments, which fosters a collaborative relationship between therapist and patient.

Conclusion

Chiropractic care is an efficient and evidence-based treatment for low back pain that offers a holistic approach to patient care. By integrating chiropractic services into primary healthcare settings, patients can benefit from an effective alternative to conventional treatments, fostering better health outcomes and higher satisfaction levels.

As the body of evidence continues to grow, chiropractic care stands out as an indispensable component in the comprehensive management of low back pain.

References

1. Roseen, E. J., Bussières, A., Reichman, R., Bora, C., Trieu, J., Austad, K., Williams, C., Fischer, R. A., Parrilla, D., Laird, L. D., LaValley, M., Evans, R. L., Saper, R. B., & Morone, N. E. (2025). A multi-level implementation strategy to increase adoption of chiropractic care for low back pain in primary care clinics: a randomized stepped-wedge pilot study protocol. Chiropractic & Manual Therapies, 33(1). https://doi.org/10.1186/s12998-024-00565-w

2. Rubinstein, S. M., Van Middelkoop, M., Assendelft, W. J., De Boer, M. R., & Van Tulder, M. W. (2011). Spinal Manipulative Therapy for Chronic Low-Back Pain. Spine, 36(13), E825–E846. https://doi.org/10.1097/brs.0b013e3182197fe1

3. Goertz, C. M., Long, C. R., Vining, R. D., Pohlman, K. A., Walter, J., & Coulter, I. (2018). Effect of Usual Medical Care Plus Chiropractic Care vs Usual Medical Care Alone on Pain and Disability Among US Service Members With Low Back Pain. JAMA Network Open, 1(1), e180105. https://doi.org/10.1001/jamanetworkopen.2018.0105