Some back and neck pain needs a doctor today, not a chiropractor. Some back and neck pain is not a case for a chiropractor and needs a doctor the same day. Go to an emergency room, not to us, if you have numbness in the groin or inner thighs, if you have lost control of your bladder or bowels, if a leg is becoming weak rather than just painful, if the pain followed a serious fall or a car crash, if you have a fever with back pain, if you have unexplained weight loss alongside it, if you have a history of cancer, or if a headache came on suddenly and is the worst you have ever had. We would rather you rang your doctor and never rang us at all.
Chiropractic care is not a substitute for medical diagnosis. Chiropractic care is not a substitute for medical diagnosis, and nothing on this website is medical advice for your particular problem. We are not physicians: we do not prescribe medication, we do not perform surgery, and we do not treat disease. What we do is examine how your spine and joints move, work on them by hand, and give you something to do between visits. If your problem turns out to be outside that, we say so and refer you — which happens often enough that you should expect it as a normal outcome rather than a failure.
Six things that genuinely help
General principles rather than a prescription. What you were given at your appointment is specific to you and takes precedence over anything on this page.
Keep moving, carefully
Bed rest was the standard advice for acute back pain for decades and it made people worse. Gentle, frequent movement within what you can tolerate beats lying still. Walking is the single most useful thing most people with a sore back can do, in short bouts, several times a day.
Heat or ice, whichever helps
There is no strong evidence that one beats the other for most back pain, and there is no need to agonise over it. Ice tends to suit the first day or two of a fresh injury; heat tends to suit stiffness and muscle spasm. Use whichever makes you feel better, twenty minutes at a time, with a cloth between it and your skin.
Sleep in the position that hurts least
There is no single correct sleeping position. Side-lying with a pillow between the knees suits most sore backs; lying on your back with a pillow under the knees suits others. A neck likes one pillow that fills the gap between the head and the shoulder, and dislikes two.
Get up every half hour
If you sit for a living, a timer is worth more than a chair. Thirty minutes of sitting, then stand, walk to the window and back, and sit down again. The best posture is genuinely the next one.
Lift with your hips, not your back
Feet apart, hips back, load close to the body, and turn with your feet rather than twisting through the waist. This matters most for the things you do not think of as lifting — a laundry basket, a toddler, a bag out of a car boot at an angle.
Do the exercises
Two or three things, ten minutes, most days. This is the part that changes the outcome and it is the part everybody drops first. If what we gave you is too hard, too long or too boring to actually do, tell us and we will give you something you will do instead.
The hard part
Why people stop doing the exercises
Almost everybody does. It is so predictable that we plan for it rather than treating it as a character flaw.
The usual reasons are that the programme was too long, too dull, too hard, or scheduled at a time of day that does not exist in your week. All four of those are design errors on our part rather than failures on yours, and all four are fixable — but only if you say so. Telling us you have not been doing them is genuinely useful information and it will not be met with disappointment.
What does not work is quietly not doing them while we both carry on as though you were, because then we are adjusting a plan on the basis of data that is not real. Two exercises you will actually do beats six you will not, every time.
Questions
Between visits — the questions we are asked most
Heat or ice?
Whichever makes you feel better — there is no strong evidence that one beats the other for most back pain, and it is not worth agonising over. Ice tends to suit the first day or two of a fresh injury; heat tends to suit stiffness and muscle spasm. Twenty minutes at a time, with a cloth between it and your skin, as often as helps.
Should I rest my back?
Not completely, and this is the piece of advice that changed most. Bed rest was standard for decades and it reliably made people worse: joints stiffen, muscle deconditions and confidence drains faster than the pain does. Gentle, frequent movement within what you can tolerate is better, and walking in short bouts is the most useful thing most people with a sore back can do.
What is the best mattress for back pain?
There is no single right answer and the industry would prefer you believed otherwise. Medium-firm suits most people better than very firm, which was the old advice and turned out not to hold up. The more useful question is usually your position rather than your mattress — a pillow between the knees when side-lying, or under the knees when on your back, helps a great many people.
Are inversion tables, massage guns and back stretchers worth it?
Mostly they are pleasant rather than transformative, and none of them is a substitute for loading. A massage gun is a reasonable way to make a muscle feel better for half an hour. An inversion table is traction you cannot control the dose of, and it is not appropriate for everybody. Spend the money on nothing and the ten minutes on the exercises instead.
How long should I do the exercises for?
Longer than you will want to. Pain usually improves well before capacity does, so the point at which you feel fine is roughly halfway. Most programmes here run eight to twelve weeks, and stopping at week three because it stopped hurting is the single most common reason for a repeat episode a couple of months later.
Should I use a back brace or support belt?
Occasionally, briefly, for a specific task in a bad week — and not as a habit. Worn continuously, a brace lets the muscles that ought to be doing that job stop doing it, and you come out weaker than you went in. If you have been wearing one for weeks, bring it to your next appointment and we will work out how to get you off it.
A fee agreed before the visit, not after it
Book an appointment
Pick a chiropractor and an hour from the calendar — it shows only the times each of them genuinely has free. A first visit is a full hour and costs $95 for the examination on its own, or $145 if we treat you at the same appointment. You decide which after the examination, not before.