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My sister is a chiropractor and insists that studies show spinal manipulation gets people who have back on their feet quickly. What about exercise and massage and a back brace? Aren't these good ways to deal with back pain, too? I'm having quite a bit of back pain and I'm slowly getting better without chiropractic care.

The key here may be the type of back pain and the response rate for recovery. Studies do indeed show that patients with nonspecific, acute low back pain respond well to spinal manipulation. Acute low back pain usually refers to an episode of back pain of less than six weeks' duration. Nonspecific back pain means there is no fracture, tumor, or infection. Instead, some aspect of soft tissue, joint, and/or biomechanics (the way things move) is likely the cause of the problem. Experts in the area of low back pain agree that "less is more" when it comes to treating acute low back pain. In fact, two sessions of spinal manipulation have been shown to reduce pain and disability by 50 per cent and should continue to be the first treatment choice for this type of problem. The use of exercise therapy, massage, heat and cold, traction, corsets or supports, and electrotherapy is no longer recommended for acute, nonspecific low back pain. There is not strong, consistent, or reliable evidence that these types of treatments are effective. These kinds of treatments may offer symptomatic relief for the management of chronic low back pain but they simply don't provide a "cure." Patient information and education seem to be the keys to fast, effective relief from early onset of back pain. Research studies repeatedly report these focus areas as the best way to reduce symptoms (especially pain), reduce health care costs, and prevent acute problems from becoming chronic.

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