Chronic back pain is the leading cause of disability worldwide, effecting approximately 80% of adults at some point in their life. This leaves many people asking, “What should I do for my back pain? What is the best treatment option?” While over the counter and prescription medication are one of the most common initial treatments, especially if someone visits their primary care physician, many people look for more wholistic and non-pharmaceutical treatment options. But what treatment is the most effective? Medications or a non-pharmaceutical approach such as spinal manipulation (chiropractic) or acupuncture?
While past studies have looked at all three neck and back treatment methods in isolation, few studies have compared chiropractic spinal manipulation to medication and acupuncture when resolving back and neck pain.
Fortunately, a study published in the peer-reviewed journal Spine, the leading subspecialty journal for the treatment of spinal disorders, sheds light on this question “Randomized Clinical Trial Comparing Medication, Acupuncture, and Spinal Manipulation” by Lynton G. F. Giles, DC, Ph.D., and Reinhold Muller, Ph.D., found that patients with chronic spinal pain, manipulation results in more significant short-term improvement than acupuncture or medication.
Prescription Medications And Relief From Back And Neck Pain
According to Giles and Muller, patients who repeatedly seek medical care report unmet needs and expectations . Also, patients prescribed nonsteroidal anti-inflammatory (NSAID) medications risk possible adverse reactions [2,3,4], such as gastrointestinal toxicity induced by NSAIDs . This is noteworthy because there is insufficient evidence to indicate that NSAIDs can assist in managing chronic lower backpain beyond short-term relief.
Acupuncture And The Treatment Of Back Pain
Studies of acupuncture effectiveness in relieving chronic spinal pain are mixed at best. Traditional Chinese acupuncture studies show ineffectiveness for chronic lower back pain. And while there is some evidence suggesting that other forms of acupuncture may help lower back pain, there was no evidence that acupuncture helps manage neck pain beyond the short term.
Spinal Manipulation: The Most Effective Way To Achieve Short Term and Long-Term Relief From Back Pain
After a thorough review of the overall data, Giles and Muller  concluded that spinal manipulation, if not contraindicated, results in greater improvement than acupuncture or medicine. The study confirmed previous expert opinions that favor the effectiveness of osteopathy and chiropractic for acute uncomplicated low back pain.
About the Author
Today’s blog was provided by a guest writer, Dr. Chris Gubbels a chiropractor in Fort Collins, CO. Dr. Gubbels specializes in Chiropractic Biophysics -a proven therapy for non-surgical spine correction. Dr. Gubbels is has advanced training in personal injury, scoliosis, wellness and Chiropractic BioPhysics.
 McPhillips-Tangum CA, Cherkin DC, Rhodes LA, et al. Reasons for repeated medical visits among patients with chronic back pain. J Gen Intern Med 1998; 13:289–95.
 . Rainsford KD. Side Effects of Anti-Inflammatory Drugs IV. Lancaster, The Netherlands: Kluwer Academic Publishers, 1997
 Scarpignato C, ed. NSAID-Induced Gastroduodenal Damage: Prevention and Treatment. Basel, Switzerland: S Karger AG (KARG), 1995.
 . Seager JM, Hawkey CJ. ABC of the upper gastrointestinal tract: indigestion and nonsteroidal anti-inflammatory drugs. BMJ 2001; 323:1236–9
 Lichtenstein DR, Wolfe MM. COX-2-selective NSAIDs: new and improved? JAMA 2000; 284:1298–1299
 Van Tulder MW, Scholten RJ, Koes BW, et al. Nonsteroidal anti-inflammatory drugs for low back pain. Cochrane Database Syst Rev 2000;2: CD00039.6. 91. Vernon H, Mi
 Giles LGF, Muller R. Chronic spinal pain syndromes: a clinical pilot trial comparing acupuncture, a nonsteroidal anti-inflammatory drug, and spinal manipulation. J Manipulative Physiol Ther 1999;22:376–81