Preventing Low Back Pain From Returning With A Vengeance

Tuesday, October 25th, 2016

Yet another low back study in our “win” column for common treatment protocols in a chiropractic office.

Some chiropractors simply aren’t able to employ physical rehabilitation as part of their practice. Many just do not have the space available to perform rehabilitation in a meaningful way. However, most will send exercises with the patient to be done on their own in the privacy of their homes.

Whether a chiropractor has patients actively perform rehabilitation or whether they encourage patients to be performing at-home exercises, exercise recommendations are a big part of common chiropractic treatment protocols.

Why They Did It

Not only is low back extremely common, but so is the recurrence of low back pain. The authors of this paper wanted to delineate whether or not exercise intertwined into the treatment or as post-treatment was the most effective form of implementation and what was effective in preventing recurring low back pain.

How They Did It

  • A comprehensive search was performed including CENTRAL (Cochrane Library 2009, Issue 3), MEDLINE, EMBASE, and CINAHL.
  • The search was conducted up to the year 2009.
  • Papers were accepted under specific criteria such as:
    1. Subjects having had back pain before.
    2. An intervention that consisted of exercises alone.
    3. Outcomes measuring recurrence metrics.
  • Two authors independently reviewed the material for acceptance.
  • The studies were divided into post-treatment intervention and treatment studies.
  • Results were combined with meta-analyses of subjects, treatments, controls, and outcomes.

What They Found

  • They ultimately reviewed 13 articles that reported on 9 studies with 9 interventions.
  • Four studies had low risk of bias while one had a high risk. The others were undetermined.
  • There was moderate evidence post-treatment exercise was more effective in reducing recurrence than was no treatment at the one year follow up.
  • There was moderate evidence the recurrence rate was significantly reduced in two of the study at the 1.5 years and at the 2 years follow-ups.
  • There was conflicting evidence as to whether or not exercise alone as a treatment protocol was effective.

Wrap It Up

Moderate quality evidence that post-treatment exercise programs can prevent recurrences of back pain but conflicting evidence found for exercise as the treatment itself.

Although this study was not intended to test the validity of physical therapy as a treatment itself, physical therapy is essentially exercise. The study suggests (to me) that physical therapy alone may not be the best protocol for low back pain and, in my opinion, could be better if combined with manual therapy and spinal mobilization.


Choi B, et. al., Exercises for prevention of recurrences of low-back pain. The Cochrane database of systematic reviews. 2010

Just another reason to call a chiropractor TODAY!

Research and clinical experience shows that, in about 80%-90% of headaches, neck, and back pain, in comparison to the traditional medical model, patients get good or excellent results with Chiropractic. Chiropractic care is safe, more cost-effective, it decreases your chances of having surgery, and it reduces your chances of becoming disabled. We do this conservatively and non-surgically. In addition, we can do it with minimal time requirements and minimal hassle on the part of the patient. And, if the patient develops a “preventative” mindset going forward from initial recovery, we can likely keep it that way while raising the general, overall level of health! Please feel free to leave a comment and tell me your thoughts. I’d love to hear what you think.

And….SHARE, SHARE, SHARE!! We cannot make a difference without your help.

Till next time……

The Amarillo Chiropractor Blog is written by Dr. Jeff Williams.

Amarillo TX Amarillo Pain & Accident Chiropractic Clinic provides customized chiropractic care to the Amarillo TX, Canyon TX, Pampa TX, Happy TX, White Deer TX, Dumas TX, Groom TX, Conway TX, Panhandle TX, Claude TX, Clarendon TX, Borger TX, Tulia TX, Hereford TX, Fritch TX, Bushland TX, and Vega TX communities.

Visit our main website at for customized Chiropractic in Amarillo TX.

Choose several options to schedule your appointment: call (806) 355-3000 or click the button below for our contact info.

by Jeff S. Williams, D.C.
Chiropractors in Amarillo
Spinal Decompression Amarillo
Creek Stone Integrated Care