Conservative care means getting the treatment with the least risk first. Generally you should treat with the most conservative care that will do the job. When your back hurts you should try resting it for a moment, if that doesn’t work move it around a little, stretch it. Then you can move up the line to rubbing it. If your body is unable to relieve the symptoms on it’s own then you should seek more advanced care.
The most conservative place to go to is a chiropractor. You might think that a massage therapist (LMT) would come first, I am an LMT. Massage therapists are great at treating conditions, and can recognize contraindications to care, and other conditions, but they are not trained in diagnosis. You should be seeing an LMT for preventative care. When an issue arises they should recognize it, if you haven’t already, and refer you to a chiropractor for examination and diagnosis.
The chiropractor may determine that all you need is some massage, and refer you an LMT, or physical therapy, or spinal manipulation, some other or combination of treatments. He should use the least risky, most conservative treatments at his disposal.
If those treatments fail to resolve the problem then there may be a need for something more invasive. Again starting with the least risky first your chiropractor and medical doctor should work together to determine the least risky treatment that will allow you to benefit from conservative care. For example if you can’t relax enough to get an adjustment a muscle relaxant could be beneficial. Beyond that there is pain medication, manipulation under joint anesthesia, steroid injections for inflammation, etc…
If those efforts are not enough then stronger pain management may be needed in correlation with functional rehabilitation and chiropractic. In cases such as ALS or multiple sclerosis functional treatments such as chiropractic become more palliative. It helps with the symptoms, but there is a broader chemical issue going wrong in the body that needs medication to treat, and a medical doctor to oversee.
There are also other issues such as a broken bone fragment or ruptured ligament that may need to be surgically removed or reattached. In these situations chiropractic should be used following surgical care to make sure function is restored properly.
So, chiropractors, trained in diagnosis and conservative, should be the first physician that you see, and probably be there for your rehabilitation as well. They should recognize their limitations, know when to refer, and when to provide or request complimentary care.
Chiropractors are initial care providers and case managers for functional or biomechanical issues and primary care physicians for many other issues.