What is the Best Treatment for Low Back Pain? A Comparison of Chiropractic, PT, Massage, & Surgery.

By Dr. Megan Touron

Low back pain is something that most of us have dealt with at some point in our lives. In America alone, 80% of adults will experience some form of low back pain in their life. It is known to be the leading cause of disability, preventing many individuals from being able to engage in their work as well as their everyday activities, and costs businesses $10 billion (yes, that’s with a B) a year to manage.

There are several different ways to manage low back pain. Today, we’re going to look at the four most common ways to treat low back pain: Chiropractic care, physical therapy, massage and surgery.

Which is the best solution for you? Read below to find out more about the benefits of each.

1. Chiropractic Care

How Does Chiropractic Treat Low Back Pain?

The Federal Agency for Health Care Research and Quality classifies chiropractic care as a safe and effective, drug-less form of initial professional treatment for acute low back problems in adults​. It decreases pain, increases the outcomes of physical rehabilitation and requires very few passive forms of treatment, such as bed rest.

Chiropractors perform spinal manipulation by using their hands or a device to apply a controlled force to a “subluxated” spinal joint. A subluxation is a chiropractic term for a spinal joint that is misaligned that negatively affects health and well-being, due to its influence on the nervous system . The amount of force is depending on the type of manipulation used. This removal of the subluxated joint allows the body to relieve pain and function optimally once again.

A study by The Journal of the American Board of Family Medicine discovered that Medicare would be able to save $83.5 million every year by patients replacing a visit to a doctor with a visit to a chiropractor for low back pain​.

Some of the benefits of chiropractic care include pain management, avoidance of surgery, improved mobility, recovery from injury or trauma, improved balance, and management of age related problems, as well as an overall improvement of function.

What Are the Side Effects of Chiropractic?

Side effects are usually minor such as mild discomfort, fatigue, or headache lasting less than 1-2 days. Serious complications of chiropractic care are extremely rare. Because chiropractic care is non-invasive and non-addictive, it is often much safer than other treatment options.

How Long Does it Take for Chiropractic to Treat Low Back Pain?

Low back pain can be resolved within the first 1-3 weeks with a chiropractor. Most chiropractors will continue to treat low back pain even after the initial pain has passed. Continued treatment is to further increase mobility, retrain low back posture, and treat the underlying health condition that caused the pain in the first place — all of this will help prevent future flare-ups.

What is the Success Rate of Chiropractic for Low Back Pain?

A study in 2015 showed that 94% of patients receiving Chiropractic Care for chronic lower back pain saw a 30% reduction of low back pain over 4 weeks. In the same study, only 56% of medical care recipients experienced a 30% reduction of low back pain over 4 weeks.

2. ​Physical Therapy

How Does Physical Therapy Treat Low Back Pain?

The goal of physical therapy is generally to improved the function and prevent disability from getting worse. The focus on treating pain in a physical therapy setting uses both active and passive therapies. Some passive therapies include heat/ice packs, electrical stimulation, ultrasound and manual therapies. Active therapies physical therapists use for patients with pain involve stretching and range of motion exercises, specific range of motion exercises and low impact aerobic conditioning.

Some of the benefits of physical therapy include pain management, avoidance of surgery, improve mobility, recovery from injury or trauma, improved balance, and management of age related medical problems.

Visits may last between 30-60 minutes a few times per week and frequency may change as the condition progresses.

What Are the Side Effects of Physical Therapy?

Common side effects of physical therapy include mild pain, swelling, fatigue and muscle aches/soreness lasting a few days up to a few weeks.

How Long Does it Take for Physical Therapy to Treat Low Back Pain?

The time it takes for a physical therapist to help treat low back pain is dependent on the condition and why the patient is receiving therapy. Active treatment with your physical therapist can last up to 6-8 weeks, with continuing at-home exercises after initial treatment protocol.

What is the Success Rate of Physical Therapy for Low Back Pain?

It has been found that those who sought early treatment, within 30 days of initial onset, for low back pain had greater success than those who had delayed treatment for physical therapy treatment. The success rate for physical therapy in treating low back pain has been shown to be about as effective as surgery, with fewer complications.

3. ​Massage Therapy

How Does Massage Treat Low Back Pain?

Massage therapy is a technique that dates back thousands of years. It is known to be a technique that releases the tension in the muscle and soft tissues to alleviate discomfort. There are several different types of massage that massage therapists use, each with different techniques.

What Are the Side Effects of Massage?

Temporary pain or discomfort, bruising, swelling and a sensitivity or allergy to the massage lotion or oils lasting from a few days up to a week.

How Long Does it Take for Massage to Treat Low Back Pain?

Massage mainly provides temporary relief from back pain. One study showed that most massage patients receive relief in the short term after receiving regular massages, but in the long term the symptoms will generally return.

What is the Success Rate of Physical Therapy for Low Back Pain?

Massage therapy is able to provide temporary relief of pain or discomfort. It has been suggested that for those who wish to encounter lasting benefits, they will need to continue the massage therapy indefinitely. Those with chronic low back issues may not experience as much relief as those with acute or sub-acute pain.

4. ​Surgery

How Does Surgery Treat Low Back Pain?

Most surgeons will inform their patients that, as with any other medical procedure, there are no guarantees that the operation will provide relief. Generally, this is looked at when more conservative measures are ineffective.

The type of surgery recommended will vary based on the case of the condition. The different types of back surgery include discectomy, laminectomy, fusion, artificial disc implantation and more.

What Are the Side Effects of Surgery?

Spinal surgery is the most invasive and risky of low back treatments. This is due to the potential side effects which can include: Blood clots, for instance in your legs or lungs, heart attack, stroke, herniated disk, and nerve damage, which can lead to weakness, paralysis, pain, sexual dysfunction, or loss of bowel or bladder control.

How Long Does it Take for Surgery to Treat Low Back Pain?

Dependent on healing process. In successful surgical cases, relief of low back pain can be in a little as 3 months. After initial recovery, most patients will be prescribed physical therapy to restrengthen and retrain low back muscles.

What is the Success Rate of Surgery for Low Back Pain?

Typical success rates for surgical procedures total amounts to about 26%. The other 74% of patients may have recurring back pain, need for additional surgeries, or seek other treatment options.

In conclusion, these days there are so many options on which type of care may be the best to choose when dealing with low back pain. Best piece of advice, look at where you are in the process and match up your expectations with the treatment that will be the best fit for you.

*This content is strictly the opinion of Dr. Ryan Lee and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Dr. Lee does not take responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.


Reach Health and Wellness Chiropractic is located in the Chattanooga, Tennessee area specifically in Collegedale, TN, a short distance from Ooltewah, Cleveland, East Brainerd, East Ridge, Ringgold, Apison, and Harrison.


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