An article published in the recent Evidence Based Medicine found that spinal manipulation alone is effective, and as effective as physical therapy and exercise, in the treatment of chronic lower back pain. They found the effect more short-term. In practice, many chiropractors, myself included, do not just use spinal manipulation to treat chronic lower back pain. While I do use manipulation, I also emphasize rehabilitation exercises, with a particular emphasis on core and spinal stabilization exercises. Where necessary I'll also use soft tissue work and modalities such as interferential current and ultrasound, especially for acute exacerbations. I spend time discussing activities of daily living and how they can effect the lower back. With any chronic problem, there usually is no magic bullet, but rather an approach that uses many options.
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