Lifestyle Factors and Chiropractic


As chiropractors, most patients present to us with complaints of low back pain (LBP), neck pain and headaches. It seems logical as a patient to think that the problem is always within the muscles, joints or nerve, because that’s where it’s felt, and ultimately that would be the cause of the pain, right? If only it were that simple… our jobs would be a lot easier!


It’s important to remember that what happens in the rest of our life has a significant impact on our spinal health. This insight will aim to give you understanding of how different lifestyle factors can influence your pain experience, and be potential risk factors for future episodes. We’ll also cover how we can modify these factors, and minimise the impact.


As we explored in our chronic pain insight, pain is a complex, and multifactorial experience, and is rarely due to one specific cause.


One large group of factors that can increase our risk of pain are lifestyle factors. Exercise may be the first thing that jumps into your head, and yes, it is extremely important, in fact we’ve covered that in a previous insight too. But this insight will focus on two major lifestyle factors: Sleep and nutrition.


The good news is that these are mostly modifiable, meaning we can change them to an extent. When you’re in pain, it’s important to remember that there’s lots of ways to help, and modifying lifestyle factors can have a great impact.



What’s the problem?


I think most people would agree that adequate sleep is a crucial part of a healthy lifestyle, but with busy lives, it’s easy to get stuck in a cycle of poor sleeping habits. Unfortunately, this can also impact our spinal health, as there is a significant association between chronic LBP and sleep (1). This doesn’t mean that poor sleep ‘causes’ LBP, but may increase the risk, and prolong an episode of it. However, preventing or reducing sleep problems can improve the prognosis of chronic LBP (2).


How to help


Here are some strategies that we like to advise our patients on to help improve their sleep:


Before sleep

  • Limit screen/blue exposure prior to bed
  • Limit caffeine consumption

Sleep environment

  • Make your room as dark and as quiet as possible
  • Mattress and pillow – these are completely individual, so try and find what’s most comfortable for you!
  • Sleep position – like the mattress and pillow, the best sleep position is the one that’s most comfortable for you, but we would generally advise to sleep on your back or side

Sleep habits/routine

  • Consistent sleep and wake times



What’s the problem?


The other major lifestyle factor that can influence our spinal health is our nutrition. Although we’re not experts in nutrition, as chiropractors we have to have an understanding of how our patient’s diet could be contributing to their pain experience. This is even more important for certain populations of people, such as those with chronic pain conditions, where systemic inflammation can be aggravated by specific foods.


Relationship between nutrition and pain


The relationship between what we consume and pain we experience is well established. As you would expect, habits such as smoking is a major factor for spinal pain (3), as well as alcohol consumption (4). But there may also be other less obvious nutritional effects on our pain.


Acute inflammation is needed in order to heal our bodies, but when inflammation persists (becomes chronic), it can have negative effects on the healing process. This chronic inflammation can be prolonged by certain food types such as sugar, bread, processed cereals and deep-fried foods (5).


This is also apparent in conditions that we commonly see in clinic such as osteoarthritis (OA). OA is a multifactorial condition that can be worsened by chronic inflammation. Therefore, addressing chronic inflammation in these patients is important to improve outcomes.


How to help


Some strategies that are considered effective for these conditions are:

  • A diet rich in vegetables, fruits, healthy oils, and fibre. Such as the Mediterranean diet (5)
  • Increasing consumption of long-chain n-3 fatty-acids (oily fish/fish oil supplements) (6)
  • Increasing consumption of foods that can reduce cholesterol (tree nuts, seeds, yogurts) (5)


It’s easy to get lost in the details of trendy diets, or eating very specific foods, which for most people isn’t necessarily to live a happy and healthy life. This can also make healthy eating seem unattainable for some people. Therefore, the best place to start is by nailing the basics first, and to do that we should look at the national dietary guidelines (https://www.eatforhealth.gov.au/sites/default/files/content/The%20Guidelines/n55a_australian_dietary_guidelines_summary_131014_1.pdf)


If your diet is a major impact on your health, we advise to get in touch with your general practitioner or a registered dietitian or individualised support.




  1. Kelly GA, Blake C, Power CK, O’keeffe D, Fullen BM. The association between chronic low back pain and sleep: a systematic review. The Clinical journal of pain. 2011 Feb 1;27(2):169-81.
  2. Skarpsno ES, Mork PJ, Nilsen TI, Nordstoga AL. Influence of sleep problems and co-occurring musculoskeletal pain on long-term prognosis of chronic low back pain: the HUNT Study. J Epidemiol Community Health. 2020 Mar 1;74(3):283-9.
  3. Smuck M, Schneider BJ, Ehsanian R, Martin E, Kao MC. Smoking is associated with pain in all body regions, with greatest influence on spinal pain. Pain Medicine. 2020 Sep;21(9):1759-68.
  4. Ferreira PH, Pinheiro MB, Machado GC, Ferreira ML. Is alcohol intake associated with low back pain? A systematic review of observational studies. Manual therapy. 2013 Jun 1;18(3):183-90.
  5. Elma Ö, Yilmaz ST, Deliens T, Clarys P, Nijs J, Coppieters I, Polli A, Malfliet A. Chronic musculoskeletal pain and nutrition: where are we and where are we heading?. Pm&r. 2020 Dec;12(12):1268-78.
  6. Thomas S, Browne H, Mobasheri A, Rayman MP. What is the evidence for a role for diet and nutrition in osteoarthritis?. Rheumatology. 2018 May 1;57(suppl_4):iv61-74.


About the Authors

chatswood chiro david mcnaughton

David McNaughton is a clinician and a researcher. He is the director and principal chiropractor at DMC Health & Wellness. He has an extensive background in the diagnosis and management of chronic pain. In addition to his clinical studies, David holds a Master’s of Research and PhD in Psychology. He regularly publishes his research in peer reviewed medical and psychology journals. David has taught both undergraduate and postgraduate studies in Chiropractic and Psychology at Macquarie University.



Isaac-Searant-DMC-ChiroIsaac Searant completed a Bachelor of Chiropractic Science and Master of Chiropractic at Macquarie University, and is currently enrolled in a Master of Research. His research aims to understand the clinical decisions health practitioners make about diagnostic imaging. His clinical interests include spinal pain (neck and back) and sporting injuries. Regardless of the condition, his goal as a chiropractor is to work collaboratively with patients.


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