Active Exercise After Chiropractic Treatment Yields Better Results

When treating chronic low back pain, chiropractors often advise patients to do certain active exercises as part of their treatment plan.  When patients feel immediate relief from the manual therapy, they may be reluctant to follow the exercise recommendations, thinking there would be no additional benefit.  Researchers wanted to determine if manual therapy has an immediate analgesic effect as well as what lasting effect active exercise has on the patient’s pain and disability.  

Researchers evaluated patients with chronic, non-specific, low back pain and randomly divided them into 2 groups.  One received spinal manipulation/mobilization plus active exercise.  The other received a sham therapy plus active exercise.  Patients received 8 therapeutic sessions over a time frame of 4 to 8 weeks.  Pain intensity was evaluated before and immediately after each session.  Additionally, pain intensity, disability, fear-avoidance beliefs, erector spinae and abdominal muscle endurance were evaluated after the 8th session, and at 3 and 6 month follow-ups. 

Results showed that the manual therapy had a better immediate analgesic effect than the sham therapy.  Manual therapy plus the active exercise yielded lower disability, and a trend to lower pain throughout the study.  This confirms that manual therapy has an immediate effect on pain levels.  When followed by active exercise, it also reduces functional disability and produces a larger decrease in pain for the patient.  Your doctor of chiropractic will devise a treatment plan that is best for you.  For maximum results, it is imperative to follow ALL of the directions in that plan.  Talk to your doctor about what exercises would be best for you.  Don’t have a chiropractor?  Find one at