Can a chiropractor fix chronic lower back pain?

As one of the most common musculoskeletal complaints globally, chronic low back pain can be a persistent, unwelcome presence in a person’s life. It’s a condition that moves beyond a sudden, sharp injury: it settles in, often making everyday activities a struggle. This fact sheet is designed to provide you with a comprehensive understanding of chronic low back pain, its common causes, and how a multi-faceted chiropractic approach may offer a meaningful path to relief and restored function.

In this fact sheet, Dr. Simon Nash (Chiropractor) discusses the nature of chronic low back pain, its typical causes, and the various treatments offered at Our Chiro Brisbane.

Please note: The information provided in this article is for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for a diagnosis and personalised treatment plan.

Table of contents 

• Understanding Chronic Low Back Pain
• Causes of Chronic Low Back Pain
• The Chiropractic Approach: Treatment Options
• Importance of Rehabilitation and Posture
• Diagnostic Imaging and Referral
• Frequently Asked Questions (FAQs)
• Book a Consult with Our Chiro Brisbane
• References
• Video Transcript

Understanding Chronic Low Back Pain

Chronic low back pain is a condition that lingers. Unlike acute pain, which is sharp and immediate, chronic pain is defined by its duration. According to Dr. Nash, it’s a long-standing issue that has persisted for an extended period.

“Chronic low back pain is usually characterised by something that’s been long-standing, usually for 8 weeks or more,” explains Dr. Nash.

This type of pain rarely reaches the high intensity of an acute injury. Instead, it’s a constant, nagging discomfort that becomes a part of daily life. Dr. Nash characterises this discomfort on a simple scale: “usually with that sort of patient, they’re having a pain range of if one was nearly no pain or 10 was the worst pain they’ve ever been in their life, it’s probably between a one and a five.” This means it’s a noticeable pain they can live with, yet it constantly affects their wellbeing and ability to move freely.

In contrast, acute low back pain is described as sudden and intense: “a five out of 10 to a 10 out of 10, and that usually comes on suddenly,” such as a muscle spasm after a strenuous activity like moving a fridge.

Causes of Chronic Low Back Pain

The causes of chronic low back pain are typically related to wear and tear, imbalances, and long-term mechanical stresses on the body. Identifying the specific source of the pain is the critical first step in developing an effective treatment strategy.

Dr. Nash identifies several key contributors:

1. Arthritis: Degenerative changes in the spinal joints (osteoarthritis) can cause ongoing stiffness and pain.
2. Poor Posture and Ergonomics: Sustained, incorrect sitting or standing positions, particularly when sitting at a desk, can place undue stress on the spine and supporting muscles.
3. Muscle Imbalances: Weakness or tightness in certain muscle groups—often the core, glutes, or hip flexors—can prevent the spine from being properly supported and stabilised. These imbalances can stem from sporting activities or a sedentary lifestyle.
4. Joint and Disc Issues: The pain can originate from various anatomical structures in the lower back, including:

• The vertebral joints themselves.
• The discs that cushion the vertebrae.
• Sacroiliac (SI) joint pain, which affects the large joint connecting the sacrum (base of the spine) and the ilium (pelvic bone).

These underlying issues create areas of poor function that must be addressed for long-term relief.

The Chiropractic Approach: Treatment Options

The core of chiropractic management for chronic low back pain is to restore function to the problem areas. Treatment is highly individualised, focusing on a combination of in-clinic therapies and at-home rehabilitation.

“Chronic low back pain we would treat more with rehabilitation exercises,” states Dr. Nash. “So we would give the patient some exercises to do at home but we’d also in the clinic want to try and restore the function around the problem with that joint or that area.”

A multi-modal approach is typically employed, utilising several techniques to target pain, inflammation, and joint dysfunction:

Spinal Adjustments and Mobilisation

Chiropractic spinal adjustments (also known as manipulation) aim to restore proper movement and function to restricted joints in the spine. By correcting biomechanical function, this treatment can alleviate pain.

“Some of the treatments we use for chronic low back pain include adjustments or manual adjustments where we will move the joints and try and restore that biomechanical function which would then obviously alleviate pain,” says Dr. Nash.

For patients with conditions like severe chronic arthritis, where a traditional manual adjustment might be unsuitable, Our Chiro Brisbane uses gentler, low-force techniques: “We could use say for example in a case where there was a lot of chronic arthritis we could use lower force techniques such as the activator or pelvic blocking.”

Advanced Ancillary Therapies

Chiropractors at Our Chiro Brisbane also utilise a range of advanced physical therapies to manage chronic symptoms:

• Dry Needling: Used to target and release tension in trigger points (tight knots) in the muscles, which are often contributors to chronic pain.
• Cold Laser Therapy: A non-invasive treatment that uses specific wavelengths of light to interact with damaged tissue, promoting tissue repair, and reducing pain and inflammation without heat.
• Shockwave Therapy: A non-invasive treatment that delivers acoustic waves to the affected area to stimulate metabolism, improve blood circulation, and accelerate the healing process of damaged tissues.
• Taping Methods (Kinesio Taping): Applied to support muscles and joints, helping to improve functional movement and provide sustained relief between appointments.

The use of taping extends the benefits of the in-clinic treatment. As Dr. Nash notes: “The patient will have the tape on when they leave and that will help just restore the muscle function and joint function as they’re walking around while they’re not in clinic.”

Importance of Rehabilitation and Posture

For chronic low back pain, the long-term solution lies in patient empowerment and addressing the root causes through lifestyle changes and strengthening.

A systematic review published in The Spine Journal affirmed the role of supervised exercise and spinal manipulative therapy (SMT) in the treatment of chronic low back pain, finding that SMT combined with exercise provides superior outcomes for pain and function compared to SMT alone (Foster et al., 2018). The rehabilitation exercises given by a chiropractor are designed to build a strong foundation of core stability and improve muscle endurance, which is crucial for preventing future recurrences of chronic pain.

Diagnostic Imaging and Referral

While the hands-on assessment is paramount, in some cases, Dr. Nash notes that further investigation is necessary to ensure the best care.

“With chronic low back pain, obviously we want to make sure that there’s nothing underlying,” says Dr. Nash.

To confirm a diagnosis or to rule out more serious underlying pathology, chiropractors may refer patients for imaging, such as an MRI or a standard X-ray (plain film imaging). This evidence-based approach ensures that the treatment is appropriate for the patient’s specific condition. If the imaging or assessment reveals a condition that requires specialist medical attention outside the scope of chiropractic practice, Our Chiro Brisbane will facilitate the necessary referral.

“If it’s something that we can’t help in the clinic, we will refer you out to the appropriate medical specialist to help with.”

Frequently Asked Questions (FAQs)

Q1: What is the main difference between acute and chronic low back pain? A: Acute pain is severe (5/10 or more) and sudden, often lasting less than 8 weeks. Chronic pain is usually milder (1/10 to 5/10) and has persisted for 8 weeks or more.

Q2: Will I need to have my back “cracked” to fix my chronic pain? A: Not necessarily. Treatment is tailored to you. While manual adjustments are a common technique, we also use low-force methods like the Activator or pelvic blocking, along with dry needling and laser therapy, especially if you have arthritis or find manual adjustments uncomfortable.

Q3: How long does it take for chiropractic care to fix chronic low back pain? A: The timeframe varies based on the cause (e.g., arthritis, disc issue) and how long the pain has been present. Chronic issues require restoring long-standing functional problems. You may notice improvements quickly, and research suggests manual therapy can lead to faster recovery times.

Q4: Can poor posture really cause chronic low back pain? A: Yes. Prolonged poor posture, especially from sitting at a desk, creates sustained stress on the spinal joints, discs, and muscles, leading to imbalances and eventually chronic discomfort.

Q5: What is the role of exercises in treating chronic back pain? A: Exercises are vital. They help strengthen your core and supporting muscles, improving your body’s ability to stabilise the spine and correct muscle imbalances, which is key to preventing the pain from returning.

Q6: Is it safe to exercise with chronic low back pain? A: Generally, yes, but the type of exercise matters. Your chiropractor will prescribe specific, gentle exercises tailored to your condition to ensure they help, not hinder, your recovery.

Q7: What is Sacroiliac (SI) Joint Pain? A: SI joint pain is discomfort in the joint that connects the base of your spine (sacrum) to your pelvis (ilium). This is a common cause of pain in the lower back and buttocks that we treat in the clinic.

Book a Consult with Our Chiro Brisbane

We recognise that living with chronic low back pain can be exhausting and demoralising. It’s the constant, subtle barrier that keeps you from being fully present for your family, work, or hobbies. You don’t have to simply live with this pain.

At Our Chiro Brisbane, our focus is on uncovering why your pain is chronic, not just treating the symptoms. We use a comprehensive, evidence-based approach—combining hands-on techniques, advanced technology like Cold Laser Therapy and Shockwave Therapy, and personalised rehabilitation exercises, to restore function and empower you to manage your spinal health long-term.

Take the step towards a life with greater comfort and mobility. Let us help you break the cycle of chronic pain.

Book an appointment with Our Chiro Brisbane today to start your recovery.

References

Foster, N. E., Anema, J. R., Cherkin, D., Chou, R., Cohen, S. P., Gross, D. P., … & Koes, B. W. (2018). Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet, 391(10137), 2368-2383. https://doi.org/10.1016/S0140-6736(18)30489-6

Video Transcript

Can a chiropractor uh fix or help uh chronic low back pain? So, we see a lot of chronic low back pain in the clinic. So, chronic low back pain is usually characterised by something that’s been long-standing, usually for 8 weeks or more. So, usually with that sort of patient, they’re having a pain range of if one was nearly no pain or 10 was the worst pain they’ve ever been in their life, it’s probably between a one and a five. uh something that they can live with every day, but they notice as well. Uh acute low back pain is something that’s more like a five out of 10 to a 10 out of 10, and that usually comes on suddenly. So, that could be like a back spasm or something like that when you’ve helped someone move a fridge. Uh chronic low back pain can be caused by things such as arthritis, poor posture, um muscle imbalances, whether that be from sporting or even just sitting at a desk or poor ergonomics. So chronic low back pain we would treat more with rehabilitation exercises. So we would give the patient some exercises to do at home but we’d also in clinic want to try and restore the function around the the problem with that that joint or that area. Uh those problem areas can come from joints, discs, sacral iliac joint pain which is the the joint between the sacrum and the illium um in your low back. So some of the treatments we use for chronic low back pain uh include adjustments or manual adjustments um where we will move the the joints and try and restore that biomechanical function which would then obviously alleviate pain. We could use say for example in a case where there was a lot of chronic arthritis we could use lower force techniques such as the activator or pelvic blocking. Um other helping techniques that we use would be dry needling. We could use cold laser, shockwave therapy, um, and other taping methods such as kinesisio taping. So that will help with a more chronic case. The patient will have the tape on when they leave and that will help just restore the muscle function and joint function as they’re walking around while they’re not in clinic. With chronic low back pain, obviously we want to make sure that there’s nothing underlying. So sometimes we will also refer out for imaging whether that be uh an MRI or whether that be plain film imaging. So, just a normal standard X-ray and then we will assess that and if it’s something that we can’t help in clinic, we will refer you out to the appropriate uh medical specialist to help with.