A randomised controlled trial of spinal manipulative therapy in acute low back pain

Jüni, Peter; Battaglia, Markus; Nüesch, Eveline; Hämmerle, Gerard; Eser, Prisca; van Beers, Roger; Vils, Daniel; Bernhard, Jürg; Ziswiler, Hansruedi; Dähler, Madeleine; Reichenbach, Stephan; Villiger, Peter M (2009). A randomised controlled trial of spinal manipulative therapy in acute low back pain. Annals of the rheumatic diseases, 68(9), pp. 1420-27. London: BMJ Publishing Group 10.1136/ard.2008.093757

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OBJECTIVE: To determine whether treatment with spinal manipulative therapy (SMT) administered in addition to standard care is associated with clinically relevant early reductions in pain and analgesic consumption. METHODS: 104 patients with acute low back pain were randomly assigned to SMT in addition to standard care (n = 52) or standard care alone (n = 52). Standard care consisted of general advice and paracetamol, diclofenac or dihydrocodeine as required. Other analgesic drugs or non-pharmacological treatments were not allowed. Primary outcomes were pain intensity assessed on the 11-point box scale (BS-11) and analgesic use based on diclofenac equivalence doses during days 1-14. An extended follow-up was performed at 6 months. RESULTS: Pain reductions were similar in experimental and control groups, with the lower limit of the 95% CI excluding a relevant benefit of SMT (difference 0.5 on the BS-11, 95% CI -0.2 to 1.2, p = 0.13). Analgesic consumptions were also similar (difference -18 mg diclofenac equivalents, 95% CI -43 mg to 7 mg, p = 0.17), with small initial differences diminishing over time. There were no differences between groups in any of the secondary outcomes and stratified analyses provided no evidence for potential benefits of SMT in specific patient groups. The extended follow-up showed similar patterns. CONCLUSIONS: SMT is unlikely to result in relevant early pain reduction in patients with acute low back pain.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology, Clinical Immunology and Allergology

UniBE Contributor:

Jüni, Peter; Battaglia, Markus; Nüesch, Eveline; Eser, Prisca; Ziswiler, Hans Rudolf; Dähler, Madeleine; Reichenbach, Stephan and Villiger, Peter

ISSN:

0003-4967

ISBN:

18775942

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:03

Last Modified:

11 Nov 2015 15:33

Publisher DOI:

10.1136/ard.2008.093757

PubMed ID:

18775942

Web of Science ID:

000268888600008

BORIS DOI:

10.7892/boris.27508

URI:

https://boris.unibe.ch/id/eprint/27508 (FactScience: 108157)

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