Chiropractic or Surgery? What the Research Says for Low Back Pain

Surgery might sound like the fastest way to fix low back pain, but it’s not always the most effective—or safest—option.

Low back pain is the leading cause of disability worldwide, and yet most people who experience it will get better without surgery. In fact, a landmark study published in the journal Spine found that patients with sciatica due to a herniated disc had similar outcomes whether they had surgery or chose non-surgical care over the long term.

So when is chiropractic a better first choice?

Here’s what research supports:

• A 2018 study in JAMA Network Open found that patients who received spinal manipulative therapy (SMT) for low back pain had significantly less pain and disability after six weeks compared to those who received usual medical care.

• Chiropractic is less invasive, lower risk, and more cost-effective than surgery. Spinal surgery, even with the best intentions, comes with risks such as infection, nerve damage, scar tissue formation, and long recovery times.

• A review published in the journal Healthcare (2022) concluded that manual therapies like chiropractic should be considered as a first-line treatment for many patients with back pain, especially before invasive procedures are explored.

When is surgery appropriate?

Surgery may be necessary in cases of:

• Severe nerve compression causing muscle weakness or loss of bowel/bladder control

• Spinal instability or deformity

• Failure of conservative care after several months

But these are the exceptions—not the rule.

Bottom line:

If you or someone you know is considering back surgery, it may be worth exploring chiropractic first. A well-trained chiropractor can help identify the root cause, provide hands-on treatment, and guide you toward recovery—without the scalpel.