By Matthew Bennett and Matt Cunningham
If you have been living with persistent back or neck pain for months or even years, you are far from alone. Chronic spinal pain is one of the most common reasons people over 50 seek help, and it can quietly chip away at the things that matter most: walking the dog along Hove seafront, keeping up with the grandchildren, tending the garden, playing golf or simply getting through a working day without discomfort.
The good news is that research into non-surgical treatment options is growing. A recent systematic review has looked specifically at spinal manipulative therapy (the hands-on technique chiropractors use) in older adults with chronic spinal conditions. The findings are encouraging and worth understanding clearly before deciding what to do next.
This article explains what the evidence says, who is most likely to benefit and how a chiropractor in Brighton might be able to help as part of a broader, personalised approach to your care.
What Is Chronic Spinal Pain and Why Does It Affect Older Adults Differently?
Pain is described as chronic when it has been present for three months or more. In the spine, this often reflects a combination of factors: age-related changes in the discs and joints, reduced muscle support, previous injuries, and sometimes the cumulative toll of a lifetime of sitting, standing and moving.
Older adults face some additional layers of complexity. Many people over 60 are managing more than one health condition, taking regular medications and may have had surgery or fractures in the past. Recovery from flare-ups can take longer and some people understandably worry about whether hands-on treatment is safe for them.
These are exactly the right questions to ask and they are central to how a good chiropractor or physio approaches care for older patients.
What Is Spinal Manipulative Therapy?
Spinal manipulative therapy (SMT) is a hands-on treatment in which a trained clinician applies controlled, targeted pressure to joints of the spine. The aim is to improve movement, reduce stiffness and support the body’s capacity to function more comfortably.
You may have heard it described as a “chiropractic adjustment.” In practice, modern chiropractic care has moved well beyond this single technique. One of our chiropractors or physiotherapists in Brighton offering evidence-informed care is likely to combine spinal manipulation with:
- Joint mobilisation: gentler, rhythmic movements to ease stiffness
- Exercise rehabilitation: targeted movements to build strength and support the spine
- Postural and ergonomic advice: particularly relevant if you work from home or spend long hours at a desk
- Home management strategies: simple self-care steps you can do between appointments
- Lifestyle recommendations: guidance on activity, sleep and keeping moving safely
Treatment is always tailored to the individual. What works for a 55-year-old runner is not the same as what is appropriate for a 72-year-old with osteoporosis and spinal stenosis.
What Does the Latest Research Show?
A recent systematic review published in the Journal of Manipulative and Physiological Therapeutics examined randomised controlled trials (RCTs) involving older adults with chronic spinal conditions. Conditions included in the review were:
- Chronic low back pain
- Chronic neck pain
- Lumbar spinal stenosis
- Combined neck and back disability
Researchers compared spinal manipulative therapy against other conservative (non-surgical) treatment approaches, including exercise programmes, medical management and home-based advice.
The overall conclusion was that spinal manipulation can be a reasonable treatment option for older adults, producing results broadly comparable to other recommended non-surgical approaches. This is meaningful, because it places chiropractic care firmly within the mainstream of conservative management, not as an alternative, but as a legitimate option alongside physiotherapy and structured exercise.
Chronic Neck Pain: Where the Evidence Is Strongest
For chronic neck pain, the review found the most encouraging results. Older adults receiving spinal manipulative therapy often saw improvements in pain levels and function that were similar to and in some cases slightly better than other conservative approaches.
This is consistent with the wider evidence base. A Cochrane-level systematic review by Gross et al. found that manipulation and mobilisation produced benefits for chronic neck pain, particularly when combined with exercise.
If you have been struggling with neck pain that has not responded to rest or over-the-counter painkillers, this evidence suggests that seeing a chiropractor in Brighton is a reasonable, evidence-supported next step.
Chronic Low Back Pain: A Comparable Option, Not a Cure-All
For chronic low back pain, the research picture is more nuanced. The evidence suggests that spinal manipulation performs similarly to other conservative treatments, including exercise and physiotherapy, rather than outperforming them.
This might sound underwhelming, but it is actually useful to know. It means that for patients who have not responded to other approaches, chiropractic care offers a credible alternative. It also reinforces the growing consensus that no single treatment “beats” chronic back pain on its own: success tends to come from a combination of approaches.
This is consistent with NICE guidance on chronic primary pain (NG193, 2021), which recommends considering a range of non-pharmacological therapies, including exercise, manual therapy and psychological support, rather than relying on medication alone.
Lumbar Spinal Stenosis: Promising Early Findings
Lumbar spinal stenosis (a narrowing of the spinal canal that can cause lower back pain, leg pain, and difficulty walking) is one of the most common age-related spinal conditions. It affects a significant proportion of adults over 60 and can seriously limit activity.
The systematic review identified some positive early findings for spinal manipulation in people with spinal stenosis, though the authors noted that more research is needed before strong conclusions can be drawn.
What is clear is that spinal stenosis responds best to active, movement-based management and a chiropractor at a clinic like Sundial with a multidisciplinary approach can contribute to this through a combination of hands-on treatment, exercise guidance and referral to physiotherapy where appropriate.
If walking any distance causes pain or heaviness in your legs that eases when you sit or bend forward, this pattern can be characteristic of stenosis and is well worth an assessment by one of our chiropractors..
Why Chiropractic Care Works Best as Part of a Broader Plan
One of the most consistent findings across the research is that spinal manipulation tends to work best alongside other treatments, not in isolation. This mirrors what our clinicians see in practice: the patients who do best are those who engage with exercise, take an active role in their own recovery and follow personalised self-management advice.
At Sundial Clinics, this is exactly how care is approached. Rather than offering manipulation as a standalone treatment, the clinic’s chiropractors work within a multidisciplinary team that includes physiotherapists and massage therapists, meaning your care can be coordinated and adapted as your needs change.
A comprehensive plan for chronic spinal pain in an older adult might include:
- Chiropractic treatment to improve joint movement and reduce pain
- Physiotherapy to address muscle strength, balance and function
- Sports massage therapy to ease muscle tension and support recovery
- Exercise rehabilitation tailored to your capacity and goals
- Self-management advice so you feel confident managing symptoms at home
- Activity modification strategies to keep you doing the things you enjoy
Is Chiropractic Care Safe for Older Adults?
Yes, for most older adults, chiropractic care is safe and effective, but proper assessment is essential before treatment begins.
Our chiropractors or physio’s will review your health history carefully, considering factors such as:
- Bone density and osteoporosis risk
- Previous surgery, fractures or joint replacements
- Current medications (including blood thinners)
- Other medical conditions
- Your overall mobility and functional capacity
Where there are specific concerns, for example, significant osteoporosis, a chiropractor can modify their technique considerably. Gentler mobilisation approaches can often be used in place of high-velocity manipulation. The goal is always to find the safest and most appropriate treatment for you as an individual.
Our chiropractors also know when to refer. If your symptoms suggest a problem that needs medical investigation such as nerve compression, significant neurological symptoms or red flags for a more serious condition, we will tell you clearly and direct you to the right source of help.
Simple Self-Help Steps That May Support Your Recovery
While professional assessment is valuable for persistent pain, there are some evidence-based self-help measures that many people with chronic back and neck pain find useful:
Keep moving. Bed rest and avoiding activity are no longer recommended for most types of chronic spinal pain. Gentle, regular movement like walking, swimming, yoga or tai chi can help maintain mobility and reduce pain over time.
Strengthen your core. Research consistently shows that targeted strengthening exercises support spinal health. Your chiropractor or physiotherapist can advise on what is appropriate for you. Alternatively click here for Sundial’s Best Three Back Exercises To Do At Home
Check your posture and workstation. If you work from home or spend long periods at a desk, small adjustments to your screen height, chair and sitting habits can make a meaningful difference. The so-called “90-90-90” rule (hips, knees and elbows at right angles) is a useful starting point.
Manage stress. The relationship between stress and pain is well established. Chronic stress can lower pain thresholds and slow recovery. Simple strategies such as regular breaks, sleep hygiene and relaxation practices can all help.
Use heat for muscle tension. A warm heat pad or hot water bottle applied to a stiff, aching area can provide short-term relief for many people. Avoid applying heat to inflamed or swollen areas.
Red Flags: When You Should Seek Urgent Help
Chronic back and neck pain is usually not a sign of anything sinister but there are symptoms that require prompt medical attention. Please seek urgent advice from your GP or 111 if you experience:
- Bladder or bowel changes alongside back pain, loss of control, retention, or altered sensation in the saddle area (around the groin and inner thighs)
- Severe, sudden worsening of pain that does not ease with rest or position changes
- Unexplained weight loss alongside spinal pain
- Pain that is constant, severe and worsening at night, not eased by position changes
- Significant weakness or numbness in your legs, arms, or hands
- A recent fall, accident or trauma that preceded your pain
Our chiropractors and physiotherapists will screen for these warning signs during assessment. If any of these apply to you, please seek medical advice before booking any manual therapy.
When Is It Worth Seeing a Chiropractor in Brighton?
A chiropractic assessment is worth considering if:
- Your back or neck pain has persisted for more than three weeks and is affecting your daily life
- You have tried rest, over-the-counter pain relief or waiting it out without lasting improvement
- You want a professional opinion on what is causing your pain and what your options are
- You are managing a condition such as spinal stenosis and want to explore non-surgical management
- You are keen to stay active whether that is walking along the South Downs, playing golf at Brighton and Hove Golf Club or keeping up with the gardening, but pain is getting in the way
- You want a clinic that will assess you properly, explain your findings clearly and refer on if something else needs attention
A good initial assessment should leave you feeling clearer, not more anxious. You should understand what the likely cause of your pain is, what your options are and what a realistic treatment plan might look like.
The Bottom Line
The evidence is reassuring: spinal manipulative therapy is a credible, evidence-supported treatment option for older adults with chronic back and neck pain. It is not a miracle cure, and it is not right for everyone but for many people, it offers real relief comparable to other recommended approaches, particularly for chronic neck pain and lumbar spinal stenosis.
The best results come from treating it as one part of a broader, personalised plan, one that includes exercise, education and active self-management. Here at Sundial Clinics in Brighton, that kind of joined-up, patient-centred care is what the team provides.
If you are unsure whether chiropractic care is right for you, the sensible first step is a thorough assessment. You will come away with a clearer picture and that is always a good place to start.
Frequently Asked Questions
Is chiropractic care suitable for people over 65? Yes, for most people. Your Sundial chiropractor will carry out a thorough health assessment before beginning any treatment, taking into account your medical history, bone density, current medications and overall health. Treatment techniques can be adapted to suit your individual needs and comfort level. If anything in your history requires a different approach or a referral elsewhere, your chiropractor will explain this clearly.
How many sessions might I need? This varies depending on the nature and duration of your pain, your overall health and how you respond to treatment. After an initial assessment, your chiropractor should be able to give you a realistic indication of what to expect. For chronic conditions, a course of several sessions is typical, with the goal of reducing your dependence on treatment over time rather than creating a long-term dependency.
Can I see a chiropractor if I have osteoporosis? Osteoporosis requires careful assessment but does not automatically rule out chiropractic care. Gentler techniques, such as soft-tissue work, mobilisation, and exercise advice, can often be used safely. Your chiropractor will review your bone health history carefully and adapt their approach accordingly.
Is chiropractic care available on the NHS? In most parts of the UK, chiropractic care is not routinely available on the NHS, though some integrated services exist. Most people access chiropractic treatment privately. At Sundial Clinics, the team can discuss options and help you understand what is involved.
What is the difference between a chiropractor and a physiotherapist? Both are regulated healthcare professionals who treat musculoskeletal pain and there is considerable overlap in the conditions they manage. Chiropractors tend to have a particular focus on spinal diagnosis and manipulation, while physiotherapists may place more emphasis on movement rehabilitation and exercise. At Sundial Clinics, chiropractors and physiotherapists work within the same team, which means you benefit from both skillsets without having to go elsewhere.
I have had back surgery. Can I still see a chiropractor? Possibly, though this depends on the type of surgery, how long ago it took place and your current symptoms. Be sure to disclose your surgical history when you book. Your chiropractor will review this carefully during your assessment and advise on whether treatment is appropriate and, if so, what form it should take.
Can chiropractic care help if my back pain is related to ageing? Age-related changes in the spine, including disc degeneration, facet joint wear, and reduced flexibility, are very common and do not mean you are beyond help. Many older adults find that the right combination of hands-on treatment and targeted exercise makes a significant difference to their comfort and mobility. The aim is not to reverse the ageing process, but to help you function better and feel more confident in your body.
What if chiropractic care is not right for me? Your chiropractor will tell you honestly if they feel that another approach would serve you better. At Sundial Clinics, the multidisciplinary team includes physiotherapists and massage therapists so if a different type of treatment would be more appropriate, you can often be seen within the same clinic without the need for an external referral.
Biographies
About Matthew Bennett
Matthew Bennett is the founder and principal chiropractor at Sundial Clinics Brighton, established in 1991. With over 35 years of clinical experience, Matthew qualified from the Anglo-European College of Chiropractic in 1987 and served as President of the British Chiropractic Association for four years. As a Fellow of the Royal College of Chiropractors and former team chiropractor for Brighton and Hove Albion FC and the British Alpine Ski Team, Matthew combines evidence-based chiropractic treatment with sports performance expertise. His authority in musculoskeletal health has been recognised through national media appearances, expert witness roles and contributions to professional publications. Matthew’s commitment to clinical excellence ensures patients receive the most effective chiropractic care in Brighton.
About Matt Cunningham
Matt Cunningham qualified from AECC University College with a specialist interest in sport and exercise. He is a Licentiate Member of the Royal College of Chiropractors and an Associate Member of its Pain Faculty. Drawing on a background as a sports coach, Matt has cultivated a strong rapport with athletes, supporting them through their physical development and performance goals. In clinical practice, he delivers patient-centred care grounded in evidence-informed methods, with a commitment to understanding and meeting each patient’s individual expectations. Matt adopts a biopsychosocial approach to health and patient management, recognising the interconnected roles of physical, psychological, and social factors in wellbeing. Informed by his extensive experience in sport, he regards exercise as both a valuable treatment modality and a cornerstone of healthy lifestyle promotion and long-term self-care.
References
Coulter ID, Crawford C, Hurwitz EL, et al. Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. https://pmc.ncbi.nlm.nih.gov/articles/PMC6020029/
Gross A, Langevin P, Burnie SJ, et al. Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. https://pubmed.ncbi.nlm.nih.gov/26397370/
Chou R, Huffman LH. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. https://doi.org/10.7326/0003-4819-147-7-200710020-00007
National Institute for Health and Care Excellence. Chronic pain (primary and secondary) in over 16s. NICE guideline NG193. https://www.nice.org.uk/guidance/ng193
Young IA, Michener LA, Cleland JA, et al. Manual therapy, exercise, and traction for patients with cervical radiculopathy: a randomized clinical trial. https://doi.org/10.2522/ptj.20080283
Ammendolia C, Stuber K, Rok E, et al. Nonoperative treatment for lumbar spinal stenosis with neurogenic claudication. https://pmc.ncbi.nlm.nih.gov/articles/PMC11787928/