Recurrences of Low Back Pain During the First 12 Months After Chiropractic Treatment

This study reports a very low recurrence rate of low back pain after chiropractic treatment.  In this study, the  recurrence rate after chiropractic treatment was 13.4%.  

To put this in perspective, another study of people receiving usual non-operative care such as steriod injections for back pain from a herniated disc, have a recurrence rate of 70%!

An Observational Study on Recurrences of Low Back Pain During the First 12 Months After Chiropractic Treatment.

J Manipulative Physiol Ther. 2017 Jul – Aug;40(6):427-433. doi: 10.1016/j.jmpt.2017.03.005.

Knecht C, Humphreys BK, Wirth B.



The purpose of this study was to investigate recurrence rate and prognostic factors in a large population of patients with low back pain (LBP) up to 1 year after chiropractic care using standardized definitions.


In Switzerland, 722 patients with LBP (375 male; mean age = 44.5 ± 13.8 years) completed the Numeric Rating Scale for pain (NRS) and the Oswestry Disability Index (ODI) before treatment and 1, 3, 6, and 12 months later (ODI up to 3 months). Based on NRS values, patients were categorized as “fast recovery,” “slow recovery,” “recurrent,” “chronic,” and “others.” In multivariable logistic regression models, age, sex, work status, duration of complaint (subacute: ≥14 days to <3 months; chronic: ≥3 months), previous episodes, baseline NRS, and baseline ODI were investigated as predictors.


Based on NRS values, 13.4% of the patients were categorized as recurrent. The recurrent pattern significantly differed from fast recovery in duration of complaint (subacute: odds ratio [OR] = 3.3; chronic: OR = 10.1). The recurrent and chronic pattern significantly differed in duration of complaint (chronic: OR = 0.14) and baseline NRS (OR = 0.75).


Recurrence rate was low in this LBP patient population. The duration of complaint before treatment was the main predictor for recurrence. The fact that even subacute duration significantly increased the odds for an unfavorable course of LBP is of clinical relevance.

PubMed Reference