The most common conventional first line treatment for most low back pain syndromes are the use of NSAIDs or non steroidal anti-inflammatory drugs such as aspirin, ibuprofen, naprosyn and similar drugs.  A chiropractor’s first line treatment for low back pain is manual therapy, without the use of drugs.  The most common and most serious adverse effects associated with NSAIDs are gastrointestinal ulcers and hemorrhage with a risk factor of death due to ulcer of 400 in 1,000,000.  The most common adverse effect of chiropractic manipulation is sore muscles and the most serious adverse effect is stroke due to vertebral artery compromise when performing a cervical adjustment with a risk factor of less than 1 in 1,000,000 treatments (stay tuned for a discussion on cervical adjustments).

Gastrointestinal ulcers can be very serious and occasionally lead to fatalities due to hemmorage and perforation.  Complications do not arise from chronic long term use of NSAIDs.  A double blind trial found that 6 of 32 (19%) healthy volunteers developed a gastric ulcer that was visible on endoscopic examination after only 1 week of use at 500mg twice per day.  If deaths from gastrointestinal effects of NSAIDs were to be tabulated in the National Vital Statistics reports, these effects would constitute the 15th most common cause of death in the United States.  The bottom line is it is important to emphasize that there is no evidence to suggest that NSAIDs are any more effective for long term treatment than chiropractic care for low back pain.  Chiropractic care should be your first line of defense before turning to NSAIDs for pain relief.

Adapted from lecture at NYCC by Dr. William Lauretti, D.C.