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Nashua Chiropractics Role in Back Pain Guidelines

November 14, 2023

Guidelines and recommendations for so many things from how to correctly replace a light bulb to when to do back surgery fill our world. Guidelines are appreciated by people confronting a new challenge or a new pain for the first time. Guidelines for the care of back pain have been published for years, many recommending non-surgical care including spinal manipulation as first line treatment. Just how well are those guidelines followed by involved healthcare providers, by back pain patients? Moriarty Chiropractic found these newly published reports attention-getting and thought our Nashua chiropractic patients would, also. We can all use them to create and go along with a guideline-based treatment plan.


Your Nashua chiropractor is aware of the current guidelines to best help you, our Nashua back pain patient. Back in 2009, the American College of Physicians added spinal manipulation to its guidelines’ recommendations of suitable spinal pain care choices. (1) Moriarty Chiropractic uses the well-documented Cox® Technic System of Spinal Pain Management which has a published algorithm of decision-making for patients suffering pain below the knee and patients with pain that doesn’t extend below the knee with a goal of 50% improvement in 30 days or so of care. These guidelines were released in 1996 and have been tested in clinic-based data collections in the years since. (2) Such guidelines with research backing and proper clinical application build confidence that there is hope to our Nashua chiropractic patients!


We hope so! Nearly 64% of chiropractors say they use (Cox®) flexion distraction with their spine pain patients and have the algorithm/guideline available to them. Moriarty Chiropractic is one of those chiropractors. Beyond chiropractic, general guidelines for back pain care are also accessible. Are they followed? A newly completed review of chiropractic and OT/PT use among 146,087 adults with low back pain in the past 3 months found that chiropractic care or OT/PT care for low back pain rose after clinical guidelines recommending their care were announced in 2016. Between 2002 and 2018, a little less than a third of said adults with low back pain reported going through chiropractic and/or PT/OT with an increase to a third after the 2016 clinical guidelines were published. (3) This does demonstrate that guidelines help with treatment planning but are not always followed. In Denmark where guidelines for low back pain care are defined for primary care before referral found that 33% of patients had not gone through an adequate course of treatment in primary care before referral. The patients were on average 53 years old with nearly 50% of them saying that they had pain for more than a year, and 75% saying that they had pain below the knee. (4) Struggles in the healthcare system to abide by guidelines are seemingly global.


A group of chiropractic leaders compiled their ideas on the role of the chiropractor in his/her own practice, with his/her own patients, within the healthcare community, and within society for healthcare. Very interesting! Independently, chiropractors reported themselves as experienced and well-educated spine and musculoskeletal care experts who delivered evidence-based care based on the latest research, clinical expertise, and patient values. They provided patient-centered care that extends to cooperating with other healthcare providers with the best interest of the patient in mind. (5) Using guidelines, chiropractors are sure that they can assist their back pain patients with those patient’s best interests in mind.

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Listen to this PODCAST with Dr. Ted Siciliano on The Back Doctors Podcast with Dr. Michael Johnson as he illustrates his use of The Cox® Technic System of Spinal Pain Management to relieve a patient dealing with back pain and foot drop.

Schedule your Nashua chiropractic appointment today. Facing a serious bout of back pain is certainly not equivalent to changing a light bulb for the first time, but it’s comforting to know that there are published guidelines to navigate the way through the task! 

Nashua chiropractic guidelines to manage back pain today and tomorrow