How Does a Chiropractor Treat Back Pain?

Back pain can hijack your life. Your every movement becomes a painful reminder that something isn’t quite right. You’ve researched your treatment options. And, of course, you want to find effective relief as quickly as possible.

Many people with back pain turn to a chiropractor. But, what exactly does a chiropractor do and how does it help? More specifically, what treatment modalities are used to relieve pain? Review this simple guide to gain a better understanding of how chiropractic care can resolve your discomfort.

What is a Chiropractor?

Chiropractors specialize in treating musculoskeletal injuries and disorders. These include issues with bones, joints, muscles, ligaments, and other soft tissues. In particular, chiropractors employ drug-free and non-invasive techniques to alleviate pain and inflammation. These professionals focus on neck and lower back pain, joint discomfort, headaches, and more.

Is a chiropractor actually a doctor? Yes. However, their education and training do not qualify them as medical doctors (MDs). Nevertheless, a chiropractor earns a Doctor of Chiropractic degree (DC).

A DC degree involves extensive training in human anatomy and physiology, orthopedics, neurology, and clinical diagnoses. A DC also spends a great deal of their training learning about manipulation and adjustment techniques. In fact, chiropractors must achieve at least 4,200 hours of classroom, laboratory, and clinical experience in order to graduate.

Aside from spinal adjustments and manual manipulation, chiropractors also use other empirically proven therapies. As part of the holistic care system, they often offer counseling about dietary modification, nutrition, and healthy lifestyle choices as well.

Chiropractic Physical Examination

A chiropractor’s initial physical examination is similar to other health care providers. Of course, given the specialized nature of chiropractic care, the focus will be on musculoskeletal conditions.

The initial exam begins with a review of your medical history, current symptoms, and personal habits. Your DC will discuss the relief modalities that alleviate your pain vs. what makes it worse. In addition, a chiropractor will want to know about your activity and occupational background, family medical history, and other psychosocial issues.

Next comes the physical examination. This typically includes general tests like pulse, blood pressure, and reflexes. Chiropractors also have more specific physical tests to assess your spine health. These examinations assess for muscle tone and strength, range of motion, posture, and neurological integrity. In addition, you may be asked to move in certain ways or undergo manual manipulations to confirm a diagnosis.

Furthermore, diagnostic imaging, like x-rays or MRIs, can allow your DC to obtain a better look at the affected areas.

DCs compile all of this information to diagnose the problem. Your diagnosis will typically fall into one of three categories, such as:

  • Non-specific mechanical back pain: Discomfort caused by damage to soft tissues, facet joints, or a degenerated intervertebral disc.
  • Nerve issues: Symptoms caused by a pinched nerve or nerve root. Conditions like spondylolisthesis, a herniated disc, or spinal stenosis may be to blame.
  • Potentially serious problems: Fractures, tumors, infections, and neurological problems, which may require more involved interventions. Somewhat out of the scope of a DC’s care.

Chiropractic Care for Back Pain

Once the chiropractor has determined your diagnosis, a treatment plan is developed. This includes both short- and long-term treatment goals. Ultimately, your chiropractic visits should decrease (if not eliminate) any painful symptoms, as well as restore functional independence. This can be achieved by several methods, including:

Spinal Adjustment

The chiropractor applies manual manipulation to an area of the vertebrae that are not functioning normally. This can include high velocity, low amplitude (HVLA) thrust techniques. HVLA techniques are some of the most frequently utilized treatments by a DC. HVLA involves using short, quick thrusts over restricted joints. Doing so helps to restore normal range of motion and reduces irritation to the nerves.

Those who undergo HVLA may hear or feel a “popping” sensation during the adjustment. This sound is caused by a release of gas as the joint moves back into position. As the combination of oxygen, carbon dioxide, and nitrogen rushes out of the joints, it reduces joint pressure. A similar sensation occurs when you crack your knuckles.

HVLA manual manipulation—or realignment—techniques continue to evolve. Depending upon your condition, you may be positioned specifically in a chair or on a tabletop so that the chiropractor can effectively work the area.

Hot & Cold Therapy

Chiropractors may also apply hot or cold therapy to the lower back or joints. Cold therapy, for example, can numb the pain for a short period of time. Heat therapy, on the other hand, increases blood flow to the area, promoting accelerated healing. Combining these therapies can significantly reduce symptoms and increase overall functioning.

In addition, hydrotherapy—soaking in water at various temperatures—can be considered a form of hot and cold therapy. Hot baths, whirlpools, ice baths, or saunas can have similar effects to directly applying heat or cold to an area. In addition, water aerobics may make it easier to exercise and strengthen tender areas of the body.


A chiropractor may use massage or have a certified massage therapist on staff. Massage offers several benefits, including reduced swelling and inflammation, improved circulation, and overall muscle relaxation. In addition, massage serves to enhance endorphin levels. These naturally occurring chemicals manage pain and improve mood.


The same technology that enables doctors to examine babies in the womb can also aid with your back pain. Chiropractors use the vibrations created by ultrasounds to treat pain and speed up the healing process. Ultrasounds work by stimulating blood flow, enhancing muscle relaxation, and breaking down scar tissue.

A chiropractor may choose from two types of ultrasound therapy—thermal and mechanical. Thermal ultrasound therapy typically works best with chronic conditions, whereas mechanical ultrasound therapy can relieve some acute injuries.

Electrostimulation or TENS

Gentle electrical impulses delivered by carefully placed electrodes can also lessen back pain when used correctly. Specifically, electrical stimulation can reduce muscle spasms and inflammation. In addition, transcutaneous electrical nerve stimulators (TENS) can disrupt pain signals from reaching the brain.

Exercise Routines

Your chiropractor may create an exercise routine to complement other treatments. After all, exercise is a great way to feel better and function better overall. A strengthening and stretching routine can stabilize muscles and increase flexibility. In addition, aerobic exercise promotes health by increasing circulation, improving digestion, and maintaining muscle tone.

Exercise routines prescribed by your DC can make a big difference. Your DC understands specific conditions and can guide you in the most effective exercises. This may save time and potential injury, especially when compared to hitting the gym on your own or using a personal trainer who isn’t familiar with your medical history.

Suggesting Lifestyle Changes

The things we do every day can also contribute to back pain. A chiropractor does more than simply address your symptoms. In fact, by obtaining a comprehensive understanding of your lifestyle, a DC can make helpful suggestions for improving your overall health.

This can include:

  • Dietary Modification: Our diets can cause inflammation, fatigue, and vitamin or mineral deficiencies. Choosing whole, nutritious foods boosts energy, reduces inflammation, and improves overall health. A chiropractor can also assist with meal planning and choosing the best supplements for your condition.
  • Activity Modification & Ergonomics: What we do (or sometimes don’t do) can place added stress on the back. Becoming aware of how your job, exercise routine, or hobbies may contribute to back pain can play a big role in your recovery. A DC can recommend modifications that can actually change your life.

Chiropractic Care Isn’t for Everyone

Treatments offered by a chiropractor can be helpful for many with back pain. There are, however, some conditions where other interventions are necessary. They include:

Consulting with a board-certified orthopedic spine surgeon can help you decide if chiropractic care is a safe option. In addition, an orthopedic doctor can empower you with more choices to treat your back pain. Some people find minimally invasive spine surgery—combined with other therapies—effective at addressing their symptoms.

The Advanced Spine Center uses a multidisciplinary team to give those who suffer from back pain a variety of treatment options. Everyone experiences back pain differently. That’s why we believe in an individual, collaborative approach.

Schedule a consultation with The Advanced Spine Center today to find out how we can help you live a happier, more productive life!