Downtown Chiropractic Newsletter

Study Compares Medication, Acupuncture, and Spinal Manipulation for Chronic Spinal Pain

Long-Term Follow-Up of a Randomized Clinical Trial Assessing the Efficacy of Medication, Acupuncture, and Spinal Manipulation for Chronic Mechanical Spinal Pain Syndromes

Objective: To assess the long-term benefits of medication,

"In patients with chronic spinal pain syndromes, spinal manipulation . . . may be the only treatment modality . . . that provides broad and significant long-term benefit."

needle acupuncture, and spinal manipulation as exclusive and standardized treatment regimens in patients with chronic (>13 weeks) spinal pain syndromes.

Study Design: Extended follow-up (>1 year) of a randomized clinical trial was conducted at the multidisciplinary spinal pain unit of Townsville's General Hospital between February 1999 and October 2001.

Patients and Methods: Of the 115 patients originally randomized, 69 had exclusively been treated with the randomly allocated treatment during the 9-week treatment period (results at 9 weeks were reported earlier). These patients were followed up and assessed again 1 year after inception into the study reapplying the same instruments (ie, Oswestry Back Pain Index, Neck Disability Index, Short-Form-36, and Visual Analogue Scales). Questionnaires were obtained from 62 patients reflecting a retention proportion of 90%. The main analysis was restricted to 40 patients who had received exclusively the randomly allocated treatment for the whole observation period since randomization.

Results: Comparisons of initial and extended follow-up questionnaires to assess absolute efficacy showed that only the application of spinal manipulation revealed broad-based long-term benefit: 5 of the 7 main outcome measures showed significant improvements compared with only 1 item in each of the acupuncture and the medication groups.

Conclusions: In patients with chronic spinal pain syndromes, spinal manipulation, if not contraindicated, may be the only treatment modality of the assessed regimens that provides broad and significant long-term benefit.

Muller R, Giles LGF. Journal of Manipulative and Physiological Therapeutics. January 2005; Vol. 28, No. 1

Newsletter and article archive:

• Early Predictors of Lumbar Spine Surgery after Occupational Back Injury
  
• Spinal manipulation compared with back school and with individually delivered physiotherapy for the treatment of chronic low back pain
  
• Pilot Study Suggests Chiropractic Reduces Health Care Costs, Need for Surgery
  
• Relief for Aching Backs: Consumer Reports May 2009
  
• Chiropractic and Children: Shown to be Safe
  
• Long-Term NSAIDs May Not Be Useful for Osteoarthritis
  
• Study Compares Medication, Acupuncture, and Spinal Manipulation for Chronic Spinal Pain
  
• Chiropractors rejoice: Study hints at benefit of chiropractic for back pain
  
• Study Compares Medication, Acupuncture, and Spinal Manipulation for Chronic Spinal Pain
  
• Vitamin E -- The REAL Truth
  
• Efficacy of preventive spinal manipulation for chronic low-back pain
  
• Cracking the Problem of Back Pain
  
• Getting an accurate back pain diagnosis
  
• Exercise: The Ultimate Anti-Aging Pill
  
• A Randomized Trial of Combined Manipulation, Stabilizing Exercises, and Physician Consultation Compared to Physician Consultation Alone for Chronic Low Back Pain
• Objective Physiologic Changes and Associated Health Benefits of Chiropractic Adjustments in Asymptomatic Subjects