Back pain

Back pain is very common, 80% of us will suffer from it at some point. It costs the economy a lot of money! It is the second biggest reason people take time off work secondary to cold and flu.

There are many different causes of back pain and the first thing to establish is that it is nothing serious. Once this is done back pain is then usually referred to simply as ‘mechanical back pain’ however even then there are a number of different things that could be the cause. This could include the muscles, discs, ligaments, joint capsules or a combination of all of these. It is important to discover what it is that is the main pain generator (and so causing the symptoms) to enable the best form of treatment for that.

That is why here at Prime Chiropractic in Grantham we conduct a full thorough examination to discover exactly what is causing the pain and tailor a bespoke treatment to try and achieve the most effective results in as short a time as possible.



Numerous studies throughout the world have shown that chiropractic treatment, including manipulative therapy and spinal adjustment to be both safe and effective.



Manual Therapies Back and Neck Service, NHS North East Essex – Department of Health Case Study – published 19 July 2011; NHS North East Essex wanted to provide greater choice, easier access and shorter waiting times for patients suffering back and neck pain and at the same time address the unsustainably high demand on local spinal services.
Evaluation after the first 12 months of offering patients a choice of any qualified provider has identified improved patient access and choice meaning early treatment and improved outcomes; and reduced primary care consultations, imaging, medication costs and inappropriate referrals to secondary care.  Referrals to spinal surgeons have reduced by more than 25%.
To date this service has seen over 7000 patients.
In 2009, this approach to offering chiropractic, osteopathy and physiotherapy services to treat back and neck conditions was awarded the NHS Alliance ‘Acorn Award’ for alternative therapy.


Bronfort; A report into the effectiveness of manual therapy, as practiced by chiropractors, manipulative physiotherapists and osteopaths for various common musculoskeletal disorders such as back pain and other health problems  Effectiveness of Manual Therapies: the UK Evidence Report  was published in February 2010. This found evidence that spinal manipulation/mobilisation is an effective treatment for acute, subacture and chronic low back pain; migraine and cerviocogenic headache; cervicogenic dizziness; manipulation/mobilisation is effective for several extremity joint conditions; and thoracic manipulation/mobilisation is effective for acute/subacute neck pain.  The conclusions were based on the results of systematic reviews of randomised clinical trials, widely accepted and primarily UK and US evidenced-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories.


NICE Guidelines; In May 2009, The National Institute for Health and Clinical Excellence (NICE) published new guidelines to improve the early management of persistent non-specific low back pain. The guidelines recommend what care and advice the NHS should offer to people affected by low back pain. NICE assessed the effectiveness, safety and cost-effectiveness of available treatments and one recommendation is to offer a course of manual therapy, including spinal manipulation, spinal mobilisation and massage. This treatment may be provided by a range of health professionals, including chiropractors as spinal manipulation is part of the package of care that chiropractors can offer.


UK Beam Trial; Back pain, exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care. British Medical Journal Nov 2004; 329; 1377 (doi: 10.1136 /bmj. 38282. 669225.AE)

Medical Research Council; ‘Low Back pain of mechanical origin: randomised comparison of Chiropractic from hospital outpatient treatment’; Meade et al.

Medical Research Council (Follow-up-study) Trial ‘Randomised comparison of Chiropractic and hospital outpatient management for low back pain; results from extended follow up’; Meade et al.

RCGP – Clinical Guidelines for the Management of Acute Low Back Pain (1996, 1999, 2001)

Clinical Standards Advisory Group; Backpain Report 1994.

Acute Back Pain – Primary Care Project; The Wiltshire and Bath Health Commission.

Carter JT, Birrell LN (Editors) 2000. Occupational health guidelines for the management of low back pain at work – principal recommendations. Faculty of Occupational Medicine. London. Occupational health guidelines for the management of low back pain at work – leaflet for practitioners. Faculty of Occupational Medicine. London. 2000. Waddell G, Burton AK 2000. Occupational health guidelines for the management of low back pain at work – evidence review. Faculty of Occupational Medicine. London.

Chiropractic Treatment in Workers with Musculoskeletal Complaints; Mark P Blokland DC et al;Journal of the Neuromusculoskeletal System vol 8 No 1, Spring 2000

Musculoskeletal Services Framework – Department of Health  July 2006

The main treatment interventions, as recommended by the current evidence review and that of clinical guidelines is a biopsychosocial approach: a) Guidance on activity, lifestyle, prognosis and prevention. b) Physical treatments drawn from all types of manual therapy, spinal manipulation and rehabilitation exercise. c) Advice about pain control, including non-prescription medication. d) Psychosocial interventions aimed at resolving cognitive barriers to recovery.


Non-rigid stabilisation procedures for the treatment of low back pain  – National Institute for Health and Clinical Excellence.  June 2006

States that chiropractic intervention can be used in the treatment of acute low back pain.


European guidelines for the management of acute nonspecific low back pain in primary care.  2005 Recommends the consideration of spinal manipulation for patients failing to return to normal activities.