Chiropractic treatment compares well with other methods of non-surgical treatment over the first 6-12 weeks of pain. Several randomized controlled studies (RCT) have shown similar improvement in pain and activity with chiropractic therapy compared to standard physical therapy and other pain management techniques. In my understanding, chiropractic is directed toward correction of subluxations in the spinal column. A subluxation is a partial slipping of a joint, as opposed to a dislocation in which the joint has come apart. Subluxations in facet joints in the spine could or might irritate the exiting spinal nerve and.or cause localized back pain and muscle spasm. The techniques and process of spinal adjustment probably are similar to heat and massage in physical therapy treatments.
A limitation of chiropractic and other methods of non-operative treatment of back pain is recurrence. Often pain is temporary, requiring recurrent treatments and work limitations. Some of those people will probably end up having indications for an operation that may help (see Q. Will I need surgery for HNP and is it worthwhile?).