Does maintained Spinal manipulation therapy for chronic non-specific low back pain result in better long term outcome?
Senna, Mohammed K.; Machaly, Shereen A.
Source
Rheumatology and Rehabilitation Department, Mansoura Faculty of Medicine, Mansoura University.Spine: POST ACCEPTANCE, 17 January 2011
Abstract
ABSTRACT:: Study Design.A prospective single blinded placebo controlled study was conducted.Objective. to assess the effectiveness of spinal manipulation therapy (SMT) for the management of chronic non-specific low back pain (LBP) and to determine the effectiveness of maintenance SMT in long-term reduction of pain and disability levels associated with chronic low-back conditions after an initial phase of treatments.
Summary of background. SMT is a common treatment option for low back pain. Numerous clinical trials have attempted to evaluate its effectiveness for different subgroups of acute and chronic LBP but the efficacy of maintenance SMT in chronic non-specific LBP has not been studied.
Subjects and Methods. 60 patients with chronic, nonspecific LBP lasting at least 6 months were randomized to receive either
(1) 12 treatments of sham SMT over a one-month period,
(2) 12 treatments, consisting of SMT over a one-month period, but no treatments for the subsequent nine months, or
(3) 12 treatments over a one-month period, along with “maintenance spinal manipulation” every two weeks for the following nine months.
To determine any difference among therapies, we measured pain and disability scores, generic health status, and back-specific patient satisfaction at baseline and at 1-month, 4-month, 7-month and 10-month intervals.
Results: Patients in second and third groups experienced significantly lower pain and disability scores than first group at the end of 1-month period (P = 0.0027 and 0.0029 respectively).
However, only the third group that was given spinal manipulations during the follow-up period showed more improvement in pain and disability scores at the 10-month evaluation.
In the no maintained SMT group, however, the mean pain and disability scores returned back near to their pretreatment level.
Conclusion. SMT is effective for the treatment of chronic non specific LBP. To obtain long-term benefit, this study suggests maintenance spinal manipulations after the initial intensive manipulative therapy.
Back pain often ranks as one of the top reasons for employee absenteeism and "presenteeism" (being at work but not really doing any work!) costing companies millions of dollars. Back pain afflicts approximately eight of every ten Americans during their lifetime.
Another recent study published in the Journal of Occupational & Environmental Medicine - March 2011, showed Chiropractic to be more effective than traditional medical care as well as physical therapy for patients with low back pain.
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(Source: ncbi.nlm.nih.gov)
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