Chronic back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease Study 2010.  Approximately 60% to 80% of us will have back pain at some point in our lives.  If you have chronic back pain, you are not alone.

Chronic Back Pain Study

A study was published in the peer reviewed journal “Spine” in 2003 that researched chronic low back pain.  The chronic back pain study was a randomized controlled trial comparing medication, acupuncture, and spinal manipulation.

Chronic back pain study review - Portland chiropractorMethods

The patients studied had to meet certain requirements to be included in this study such as length of uncomplicated back pain and above age 17.    The patients were randomly split into 3 groups:

  • acupuncture
  • spinal manipulation (chiropractic)
  • medication

Each group was treated 2 times a week for 9 weeks.  The medication group was administered to by a medical doctor, the acupuncture group by an acupuncturist, and the spinal manipulation by a doctor of chiropractic.


There was a significant decrease in the subjective and objective measures for those treated with spinal manipulation.  The acupuncture treatment also had a significant decrease in pain and assessment.  The medication group did not have a statistically significant decrease in any outcome measures.  By the end of the study, the manipulation group had the highest number of patients with no more symptoms (27%).  Acupuncture came in second place with 9.4% and medication group came in 3rd with 5%.  The only side effects came from the medication group: indigestion, abdominal pain, or skin rash.

Bottom Line

  • Spinal manipulation is superior to medication or acupuncture in the treatment of chronic back pain
  • Magnitude of effect: Spinal manipulation was asssessed with a decrease of 38-50% in subjective and objective measurements
  • Strength of evidence: The study was well done with strict adherence to both the treatment and the follow-up protocols



Giles LG, Muller R (2003). Chronic Spinal Pain: A randomized clinical trial comparing medication, acupuncture, and spinal manipulation. Spine. 1490-1503.