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  • Writer's pictureRiverside Chiropractic

Wait for it to pass or see a chiropractor? What is more cost effective?

When it comes to neck and back pain, a common question is if you should get treatment for the pain early, by visiting a physio, chiro or massage therapist...or wait for it to pass on its own.

It's an interesting question. Many acute (less than 6 weeks) aches and pains will pass on their own. There is also the option to try self management strategies, such as a heat pack, stretching, foam rolling, creams and rubs, or other self management strategies.

A recent trial published in chiropractic and manual therapies tried to answer this question. They investigated a sample of 409 people with neck and back pain, and assigned them to two groups, and then followed their outcomes after 1 year. The first group was advised to stay active and wait for the condition to self resolve. The second group was given manual therapy.

The results of the two groups were similar, but manual therapy outperformed advise to stay active. While it is well known, and often advised from GPs and other healthcare practitioners, that conditions will often improve on their own with time, the manual therapy group had better quality of life outcomes and more pain relief than those who were advised to stay active. Also, the costs were deemed to be better in the manual therapy group. This was determined by asking participants how much would they be willing to pay for the various treatments, and then subtracting the differences between the real-world costs applied to the participants. The researchers considered sick leave, quality of life, and other treatments that people may pursue (ie medications) and found that after a year, the costs favoured manual therapy, and were lower than the costs participants said they would be willing to pay.

This was based on one large randomised controlled trial in Europe, but there is reason to believe that the populations seeking healthcare are similar in both Europe and Australia, and the results are likely to be similar here. The strengths of the study include the large number of participants, which decreases the likelihood of confounding due to statistical anomalies. The limitations of the study include that it is based in Europe, as well as there were some drop outs from the final analysis, which is common in trials but may have impacted the findings.


Aboagye, E., Lilje, S., Bengtsson, C. et al. Manual therapy versus advice to stay active for nonspecific back and/or neck pain: a cost-effectiveness analysis. Chiropr Man Therap 30, 27 (2022).


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