Low back pain: does anything bring permanent relief?

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After writing a piece for the Globe on living with chronic low back pain and the lack of a permanent cure, I received several angry letters from chiropractors telling me I’d done a disservice to my readers by not mentioning spinal manipulation for pain relief.

“Research results overwhelmingly demonstrate that chiropractic care is safe, beneficial, cost-effective and has high patient satisfaction,” wrote chiropractor Bradley Weiss of Natick. “A greater utilization of chiropractic care for back pain could give tremendous benefit for those suffering from back pain.”

I responded by citing a review of the latest research conducted by the Cochrane Collaboration, which found that “while combined chiropractic interventions slightly improved pain and disability in the short term and pain in the medium term for acute and subacute low-back pain, there is currently no evidence” to determine whether or not spinal manipulation works any better than other treatments for low back pain.

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Chiropractor Peter Hill of Weston pointed out that nevertheless, I should have emphasized conservative treatments like massage, acupuncture, and chiropractor care in my piece since at least these approaches help patients manage their pain over the short-term with little risk.

I have no argument with that and received emails from several readers who told me they were helped tremendously by their acupuncturist, massage therapist, or chiropractor. I don’t doubt that some of those experiencing back pain get genuine relief from these approaches, while others mistakenly attribute their improvement to their treatment as the body heals whatever injury is causing the pain on its own.

There are those, too, who simply get no substantial relief no matter what they try.

My article, though, was focusing on long term management of back pain and how the lack of any permanent fix was moving doctors to recommend a new pain management approach that helps patients remain functional. Back pain sufferers become active participants in their treatment by learning how to exercise through the pain or mentally deal with the discomfort through relaxation techniques. Some feel better, and many remain more mobile as they feel empowered to take charge of their condition.

Are you dealing with back pain on a regular basis? What works for you?

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