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."
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
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
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