Part of the "Myth Busting" series
In our last blog post we looked at the role of painkillers in managing pain. But what role does hands-on treatment, whether done by chiropractors, physiotherapists, osteopaths or anyone else, play in reducing pain?
To clarify, when I talk about chiropractic treatment in this blog, I'm referring to all the passive techniques that chiropractors can use. This includes (but is not limited to):
- Adjustment/manipulation (the "cracking")
- Massage, with or without instruments
- Trigger point therapy (pushing on knots in the muscle)
- Passive stretching techniques (where the chiropractor holds you in a position to stretch the muscle)
- Acupuncture or acupressure
- Traction techniques (stretching along the length of the spine)
- Using the activator (the piece of equipment that looks like an epi-pen and sounds like a stapler)
- Lying you on blocks that twist your pelvis in one direction
As I mentioned in a previous blog, chiropractors can be pretty awful at communicating what it is that our treatment does. We often use terms where we know what we mean, but to someone who doesn't have medical knowledge or a background in anatomy/physiology, it can be confusing or even misleading. Terms like "your back is out", "your disc has slipped", "your pelvis is tilted". These are short-hand terms which make sense to healthcare professionals, but not to the general public. As chiropractors, we often expect a level of interpretation from our patients that is a bit unreasonable!
Let's clear up some of the confusion here. Chiropractic treatment does not:
- Move bones back into place (that would require surgery)
- Realign your spine (see above)
- Un-tilt your pelvis
- Make your muscles longer (more on this is a blog about stretching next week)
- Make your muscles stronger (that requires loading over time, ie. exercise/activity)
However, we do have good evidence that manual therapy does do the following two things very well and very consistently:
- Decrease pain
- Increase range of motion, ie. the amount your joints can comfortably move
But the important thing to know is that both of these effects are short-term. Manual therapy, when done alone, will only benefit you for a few weeks at best.
And this is why it's important for you to also do any exercises your chiropractor prescribes, and to follow any advice they give you.
Manual therapy can be a fantastic boost to getting you moving and out of pain. It's been shown to be safe, is non-invasive, generally well tolerated and can be an important part of your care. But in isolation the results are likely to be short-lived. All the research shows that it works best when combined with exercises and change in lifestyle/behaviours relating to pain.
So don't let anyone tell you that they're "fixing" your back by making it crack.