Should You Get Chiropractic Adjustments after a Back Surgery?

A chiropractor adjusts a patient.
Chiropractic may help prevent stenosis and relieve back pain. Andy Crawford/Cultural Exclusive/Getty Images

Should You Get Chiropractic Adjustments after a Back Surgery?

I sometimes peruse social media to learn more about what people with back or neck pain really want to know.  On one thread I recently read, people who still had pain after a back surgery were talking about the pros and cons of getting chiropractic adjustment.

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The plain fact is, there’s not a lot of research out on this particular question, and most of what has been published in the form of case studies.

  As far as reliability of information goes, case studies rate just above expert opinion.  In a sense, they are like medical research’s version of the anecdotal evidence.  Most of the studies on the topic of spinal manipulation after a back surgery are also retrospective, which means the information was gathered from clinical records after the treatments were given. This type of research study may leave critical information out of the results because it was not planned in advance.

Adjustments after Microdiscectomy

That said, a recent randomized controlled trial (a high-quality study design that is used to compare treatments) found that soon after a lumbar open laser microdiscectomy, manipulative rehabilitation - which involves techniques used by chiropractics - helped decrease leg pain.  

The study involved 21 patients who were between the ages of 25-69.  Participants were randomly divided into one of two groups – either the manipulative rehabilitation group or the “active control group.”  In the active control group only 9% of people in the decreased their postoperative leg pain, but in the manipulative rehabilitation group, the number jumped to 55%.

The study was conducted by Korean researchers, Kim, et. al. and was titled, “Early individualized manipulative rehabilitation following lumbar open laser microdiscectomy improves early postoperative functional disability: A randomized, controlled pilot study.”  It was published in the March 2015 issue of the Journal of Back and Musculoskeletal  Rehabilitation.

Related:  What is a Subluxation?  It Depends on Who You Ask

Post Surgery Cox Flexion Distraction Technique Adjustments

A 2011 article by Kruse and Cambron entitled, “Chiropractic Management of Postsurgical Lumbar Spine Pain:  A Retrospective Study of 32 Cases,” and published in the Journal of Manipulative and Physiological Therapeutics reviewed the charts of the author’s patients to find those who were treated with Cox flexion distraction technique after a lumbar spine surgery within a 10 year period.  The researchers reported on 32 records.

They found that those patients who got the most out of the treatment had had a combination surgery, in other words, a discectomy with either a laminectomy or fusion.  The authors surmise that the reason this group did so well was because most started with a high pain rating (so there was a lot of room for improvement.)  The authors also said that the group who benefited the least from the chiropractic treatment was the fusion only group.  They suggested that the reasons were because the people in this group were older and had more time between their surgery and their chiropractic treatment.

Related: Spinal Stenosis Surgery

If you’re still in pain after your back surgery, or if you have a new type of pain, discuss your options with your doctor.  Mention your interest in getting chiropractic treatment.  It’s best to work as a team when you can.  As Kruse and Cambron’s small study suggests, most likely the use of chiropractic to manage post-surgical pain depends on more than one factor -  on what underlies the pain, what your pre-surgery diagnosis was, what type of surgery you had, and other things.

Sources:

Kruse, R.A., D.C., Cambron, D.C., Ph.D. Chiropractic Management of Postsurgical Lumbar Spine Pain: A Retrospective Study of 32 Cases. Journal of Manipulative and Physiological Therapeutics. Volume 14, No. 6. Accessed Jan 2016. Kim, B., Ahn, J., Cho, H., Kim, D., Kim, T., Yoon B. Early individualized manipulative rehabilitation following lumbar open laser microdiscectomy improves early postoperative functional disability: A randomized, controlled pilot study. Back Musculoskelet Rehabil. March 2015. Accessed Jan 2016.

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