I see a chiropractor every time my back goes out. But sometimes I wonder if at the end of the year, I wouldn’t be just as well off without the expense of these treatments. Is there any way to tell what would happen if I didn’t get adjusted?

You are asking about comparing the long-term effectiveness of chiropractic care for chronic low back pain against the natural history (what happens without treatment). It’s a good question but somewhat difficult to answer. Without a clone of you (one to get the treatment and one who doesn’t get the treatment), there’s simply no way to know for sure.

Many studies have been done examining the benefit of chiropractic care in the acute (recent) case, subacute (one to three months after first onset of pain), and chronic phase (long-term or pain present more than three months). There is general consensus (agreement) now that chiropractic care does reduce pain for acute low back pain. The benefit does not seem to carry over in the medium and long-term time periods.

In a recent review of chiropractic care compared with other conservative treatments, the researchers doing the investigation made note of the fact that there have been no studies comparing chiropractic care with no care (letting nature take its own course).

There’s plenty of room for more study in this area. Finding out if one modality would work better than another or if all are truly needed to get the desired results would be helpful, too. Looking at subgroups of patients (i.e., treating groups of patients differently because of specific characteristics) is another area for future research.