According to Dr. Cain Dimon, physician director of the center for pain medicine at William Beaumont Hospitals in Royal Oak, Mich., spinal manipulation may be appropriate only after patients receive a full physical exam to detect the problem and undergo other types of treatments to relieve the pain first.
"I certainly don't dismiss chiropractic manipulation," said Dimon. "It can certainly help in some cases lower pain."
Overland said it's unlikely that a chiropractor would perform a spinal manipulation without first knowing the exact cause of pain.
"If a person has a herniated disc, this would've been diagnosed, said Overland. "Usually chiropractors do a full orthopedic and neurologic examination."
In fact, there are some cases where manipulation may exacerbate the pain, said Dimon.
For some experts, the problem with spinal manipulation is that it is has become an overpromising treatment for conditions outside the physiological realm of the technique. For years, chiropractors have faced criticism for claiming their practices work to cure a wide variety of ailments, including asthma and cancer.
"It's hard for me to understand physiologically how that would work," said Dimon, who cautioned against undergoing treatments without a physician recommendation.
According to Overland, the lingering controversy over spinal manipulation has less to do with the data concerning its safety or efficacy, and more to do with the resounding consensus by many conventional medical doctors spanning decades that suggests chiropractors are not an equal part of the medical community.
"There's still a lot of residual bias against the profession," said Overland. "Yes, there's risk of every medical procedure, but we need to move away from health in a bottle."
The medical community should place a larger emphasis on understanding chiropractic techniques, he said.
"What's lacking is really good research is how spinal manipulation is helping other types of chronic conditions," said Overland.