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Drugs, Acupuncture, or Manipulation for Back Pain?

Posted on: 11/30/1999
Children often play the game rock-paper-scissors to see who goes first. Scissors always win over paper. Paper wins over rock. Rock wins over scissors. When it comes to chronic back pain, patients often feel like they are playing the same game. Drugs? Acupuncture? Manipulation? But in this case, there are no clear answers.

These researchers in Australia compared drugs, acupuncture, and manipulation in this clinical trial. They found that spinal manipulation was most successful for short-term relief of chronic pain, followed by acupuncture and then medication.

The authors reviewed results from other studies and point out the following:

  • Patients taking muscle relaxants for back pain have less severe pain than patients who take no drugs.
  • Acupuncture hasn't been proven effective for back pain.
  • Manipulation is better than doing nothing, but about the same as exercise or nonsteroidal drugs.
  • Patients getting chiropractic treatment show more improvement and are happier with the results than patients treated by a family doctor.

    In this study, pain intensity and frequency were measured at two, five, and nine weeks after the first session for each form of treatment. Spine range of motion was also measured.

    Rock, paper, scissors? Drugs, acupuncture, manipulation? The authors conclude that spinal manipulation gives the best overall results. However, patients must be cleared for manipulation and free of any factors that could cause problems.

  • References:
    Lynton G. F. Giles, DC, PhD, and Reinhold Muller, PhD. Chronic Spinal Pain. A Randomized Clinical Trial Comparing Medication, Acupuncture, and Spinal Manipulation. In Spine. July 15, 2003. Vol. 28. No. 14. Pp. 1490-1503.

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