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Back pain. Should I See A Chiropractor, Osteopath, Or Another Doctor?

While there are standard drugs and other treatments for back pain, many people turn to additional therapies and alternative healthcare providers to get better. It can be a little bit confusing, as there are so many forms of therapy nowadays- chiropractic medicine, osteopathy, acupuncture, physiotherapy, and more. Which ones are the best to help treat back pain? Let’s review the benefits of alternative forms of medicine and therapies. 

Physiotherapy for back pain 

There are plenty of scientific studies supporting the benefits of physio exercises for managing low back pain, especially for low back pain. Many doctors recommend physiotherapy and other conservative measures before considering surgery for back pain. 

Physiotherapy is also useful before and after surgery, as it helps strengthen the musculoskeletal system and shorten the recovery process. 

Active exercise help reduce the pain, improve function and reduce the risk and severity of new episodes of back pain. Physiotherapy includes passive and active therapy. Active therapies involve an exercise program and stretching, while passive therapies are applied by a physiotherapist, in the form of heat or cold applications, electrical stimulation, or ultrasound therapy. While some sessions with a physiotherapist are done in a medical clinic, the therapist can create a custom exercise program for the home. 

Acupuncture for back pain 

Used for thousands of years in China and other Asian countries, acupuncture is gaining more and more popularity in the Western world. Well-designed studies support acupuncture for several health conditions, including back pain. An acupuncture session consists of inserting tiny needles at specific points on the body through the skin. For example, for low back pain, a person may have needles placed in the back of the knees, on the foot, and hip. For upper back pain, needles are inserted in the upper body like head, neck, and shoulders. 

A large study evaluating almost 20,000 participants with chronic pain found that those who received acupuncture experienced a 50% improvement in pain. Other studies found acupuncture particularly beneficial for chronic low back pain, and may even work better than pain medications. Healthcare professionals trained in Traditional Chinese Medicine (TCM) use acupuncture along with other modalities like diet and herbal supplements. In the US, naturopaths, some physiotherapists, massage therapists, and chiropractors may study acupuncture and provide it as an ad on therapy. 

Osteopathy for back pain 

In the US, doctors of osteopathic medicine (DOs) are fully licensed physicians who practice in all areas of medicine, just like medical doctors (MDs). Osteopathy focuses on prevention and has a holistic approach to health looking at improving lifestyle and environment for optimal health. DOs receive special training in treating the musculoskeletal system and have a great understanding of the connection between muscles, nerves, and bones. They use gentle hands-on techniques to relieve pain and also recommend specific exercises and lifestyle changes. A  2005 review of multiple studies published in the journal BMC Musculoskeletal Disorders supports the benefits of osteopathy for back pain management. This form of medicine was found to significantly decrease low back pain and the effects persisted for at least three months. Osteopathy can help with both acute and chronic low back pain, including sciatica. 

Chiropractic medicine for back pain 

Chiropractic treatments can also be a great choice for treating low back pain, as chiropractors have special training focused on proper alignment of the spine and other joints. 

Chiropractic treatment has been found effective to increase strength, endurance and reduce low back pain and disability, according to research. 

Some studies looked at the benefits of manual treatment for low back pain. Manual treatment includes spine and joint manipulation or mobilization, massage, and various soft tissue techniques. Osteopaths, chiropractors, and massage therapists use manual treatment. Based on a 2010 extensive research of scientific evidence from the UK, spinal manipulation is effective in adults who have low back pain and neck pain -either acute, subacute, or chronic pain as well as migraines, cervicogenic dizziness, and several joint conditions. The same study found less evidence for using spinal manipulation for sciatica, tailbone pain (coccydynia), and fibromyalgia. 

What is the difference between chiropractors and osteopaths? Chiropractors use adjustments to correct misalignments of the spine and other joints, while osteopaths focus on manipulating soft tissues through stretching and massages. Both have a holistic view of health, looking at the root cause of the symptoms,  the connection between different parts of the body, and the importance of a healthy lifestyle. However, osteopaths undergo similar training with MDs, have a license to practice medicine,  and can use the same medical  (i.e. prescribe drugs) and surgical treatments. 

Chiropractors are alternative healthcare providers- they hold a doctorate of chiropractic (DCs) and can not prescribe drugs, perform surgeries or recommend other conventional treatments. Chiropractors rely on natural supplements and herbs, in addition to chiropractic treatments.

All these therapies had been researched and found beneficial for managing back pain. If you are not sure which treatment is right for you, start with physiotherapy and explore the other options. Many alternative healthcare providers offer a free 15-minute consultation where they can learn more about your condition and answer your questions.