Extremity conditions. A 2011 systematic review and meta-analysis concluded that the addition of manual mobilizations to an exercise program for the treatment of knee osteoarthritis resulted in better pain relief than a supervised exercise program alone and suggested that manual therapists consider adding manual mobilisation to optimise supervised active exercise programs. There is silver level evidence that manual therapy is more effective than exercise for the treatment of hip osteoarthritis, however this evidence could be considered to be inconclusive. There is a small amount of research into the efficacy of chiropractic treatment for upper limbs, limited to low level evidence supporting chiropractic management of shoulder pain and limited or fair evidence supporting chiropractic management of leg conditions.
Determining a treatment strategy depends mainly on identifying the location and cause of the irritated nerve root. Although neck pain can be quite debilitating and painful, nonsurgical management can alleviate many symptoms. The doctor may prescribe medications to reduce the pain or inflammation and muscle relaxants to allow time for healing to occur. Reducing physical activities or wearing a cervical collar may help provide support for the spine, reduce mobility and decrease pain and irritation. Trigger point injection, including corticosteroids, can temporarily relieve pain. Occasionally, epidural steroids may be recommended. Conservative treatment options may continue for up to six or eight weeks.
All treatment is based on an accurate diagnosis of your back pain. The chiropractor should be well informed regarding your medical history, including ongoing medical conditions, current medications, traumatic/surgical history, and lifestyle factors. Although rare, there have been cases in which treatment worsened a herniated or slipped disc, or neck manipulation resulted spinal cord injury. To be safe, always check with your medical doctor to make sure your condition will benefit from chiropractic or other pain relief alternatives.