60: Spinal manipulation and low back pain / sciatica

19.01.24 04:51 PM By Gavin Routledge

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Spinal manipulation and low back pain / sciatica

Today’s episode is entitled “Spinal manipulation and low back pain / sciatica” and it explains why spinal manipulation won’t solve your low back pain / sciatica, but it will often relieve it. The main reasons behind this are:

  • Logic
  • Low back pain isn’t correlated with misalignments
  • Manipulation doesn’t solve pain, but it might relieve it

Logic

The logic reason behind it is if you’re hungry, food solves your hunger. An absence of food caused your hunger and having food solved the hunger. But it’s not an absence of low back manipulation that gave you low back pain, so giving it to you isn’t going to solve it. Just as it wasn’t an absence of medication that led to your low back pain / sciatica. These things won’t stop it from coming back again.

Low back pain isn’t correlated with misalignments

Low back pain / sciatica are not correlated with the sorts of things you would use manipulation to solve. Manipulation isn’t closely correlated with misalignments or vertebral subluxations. There’s evidence that manipulation will help to relieve your pain, but there isn’t any evidence that it is going to solve your pain or stop it from coming back again.

You can have twists and turns in the spine without any pain. Equally, you can have pain without any twists or turns. Not that there’s many people who are absolutely symmetrical, and this is the problem. If you go to a chiro or an osteopath or spinal manipulative therapists, they will always be able to find things that are less than perfect. Things are a little bit twisted this way, or side-bent that way or kinked forward. If you’re looking for a solution to your low back pain / sciatica, having spinal manipulation isn’t going to be it. They may be associated and be a part of the problem, but there is no evidence that manipulating them is going to solve your problem in the long run. If it did work, a lot of manipulative therapists would go out of business

Manipulation doesn’t solve low back pain, but it might relieve it

So how does it relieve it? When we manipulate a joint and it makes a cracking sound, there’s a release of endorphins and other chemicals. Endorphins are very powerful, natural opioids that make you feel better instantly. The bad news is that it’s very short-lived. You only get that buzz for a 15 to 20 minutes, at the most. This is why a lot of people click and crack their own joints. They become addicted to it because they’re getting an endorphin high. They keep having to do it again, and again, and again. And it’s one reason why some people keep going back to their manipulative therapist. They feel good and they want that feel good feeling again, so they’re on a weekly appointment schedule with their manipulative therapists.

Another way manipulation relieves pain is when you manipulate the muscles immediately or in that joint relax a little bit, which affords you to agree, to arrange in motion. You’re able to move more freely as well, which reinforces that sense of all that solve that problem. You feel better and because of that, you move more. That’s really what’s doing you good. You gain the confidence to do more because you feel better. And by doing more, you feel even better. It’s a self-sustaining positive cycle. That’s the main mechanism by which spinal manipulation relieves pain. You get an endorphin kick and relaxation of the surrounding musculature. You’re able to do more, so you feel better.

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Gavin Routledge