Chiropractor v physio: in Spinal Health Week, we investigate the best way to fight back pain


Back pain is as common as the cold, and perhaps more debilitating.
Back pain is as common as the cold, and perhaps more debilitating.

IF you’re one of the three million Australians that suffer from back problems, Spinal Health Week, from May 23-27, could be the time to get some help.

Lower back pain is Australasia’s second-most common cause of burden according to the World Health Organisation’s latest Global Burden of Disease Study.

This is being blamed on an increasingly sedentary lifestyle, with the sharp increase in computer-based jobs over the past 30 years.

The postural impacts of increased computer usage include increased pressure on the spine, with lower back pain, neck pain, headaches and tiredness some of the side effects.

Spinal Health Week encourages people to visit a chiropractor for assessment and treatment.

But Peter O’Sullivan, a specialist physiotherapist and professor of musculoskeletal physiotherapy at Curtin University, believes chiropractic intervention should perhaps not be the first port of call.

“We (physiotherapists) are front-line practitioners – we’ll screen for anything serious and then assess people to say what are the factors that are driving this problem?” Professor O’Sullivan said.

“Often chiros will say there’s something ‘out’ with your back, and there’s no evidence for that at all.

“Typically they might take an x-ray of your back, and most human beings are asymmetrical, and they’ll say ‘oh, this is out’.

“The ‘crack’ actually gives you pain relief and it makes you feel a bit more relaxed.

“A very small group of people, back pain is related to structural issues, but in the majority it’s not.”

Professor O’Sullivan, who has been researching back pain since 1993, said in most cases changes in lifestyle and exercise habits can ensure the pain is managed.

“If you’re someone whose back tenses up when you’re under pressure, or you’re sitting too long, then having strategies that you can use to get you moving and active are really effective,” he said.

“There’s evidence that manipulation can cause short-term pain relief, but the idea that something’s out and you need to keep going back to get it corrected, there’s not a good evidence base for.”

But chiropractors spend five years in tertiary training to become qualified, and deputy president of the Chiropractors Association of Australia Dr Andrew Lawrence said the profession stressed a holistic approach.

“Helping patients make positive changes, with respect to nutrition, exercise and wellness is also fundamental to maintaining normal spinal function,” said Dr Lawrence.

“Adopting healthy habits today, such as improving postural fitness, can significantly reduce the risk of injury or pain in later years.”

One thing both professions agree on is the prevalence of back problems in Australia.

“Back pain is the leading health disorder for cause of disability of all health disorders, so it’s a massive problem,” Professor O’Sullivan said.

“It’s as common as the cold.

“The majority of people will have some back pain across their lifetime.

“For a lot of people it’s not a big deal, but for a small but significant group it can ruin their lives.”