New JAMA study supports use of SMT as first line treatment for low back pain patients

A new study published in the Journal of the American Medical Association (JAMA) adds to a growing body of recent research supporting the use of spinal manipulative therapy (SMT) as a first line treatment for acute low back pain, according to the American Chiropractic Association (ACA).

The review examined randomized controlled trials, systematic reviews and other published research since 2011 to determine the effectiveness and safety of SMT for low back pain patients. Researchers found that spinal manipulation was associated with statistically significant improvements in pain and function for up to six weeks with no serious adverse side effects. The JAMA study, published April 11, comes on the heels of new low back pain treatment guidelines by the American College of Physicians (ACP) that recommend first using non-invasive, non-drug treatments, including spinal manipulation, before resorting to drug therapies.

"As the nation struggles to overcome the opioid crisis, research supporting non-drug treatments for pain should give patients and health care providers confidence that there are options that help avoid the risks and dependency associated with prescription medications," said ACA President David Herd, DC.

Just last month, ACA's House of Delegates formally approved a resolution to adopt ACP's low back pain treatment guidelines, in conjunction with chiropractic-specific guidelines from the Clinical Compass. The Clinical Compass guidelines focus on the management or co-management of low-back pain patients within a chiropractic office.

"By identifying and adopting guidelines that ACA believes reflect best practices based on the best available scientific evidence on low back pain, we hope not only to enhance outcomes but also to create greater consensus regarding patient care among chiropractors, other health care providers, payers and policy makers," added Dr. Herd.

According to a 2016 Gallup survey, more than 35 million people visit a chiropractor annually. Widely known for their expertise in spinal manipulation, chiropractors practice a hands-on, drug-free approach to health care focused on disorders of the musculoskeletal system. Chiropractors are trained to diagnose and manage cases of back pain and refer patients to appropriate medical specialists when necessary.​

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