Tuesday 2 October 2012

Does Spinal Manipulation Relieve Low Back Pain?

In patients with chronic nonspecific low back pain, spinal manipulation/mobilization therapy followed by an 8-week program of specific active exercises has been shown to decrease immediate pain and improve functional ability vs sham therapy plus active exercises, according to these findings(Balthazard et al 2012)

This study aimed to assess whether spinal manipulation/mobilization therapy had an analgesic effect.

A total of 37 patients with chronic nonspecific low back pain were monitored through 8 therapeutic sessions delivered for 4 to 8 weeks. A single physiotherapist with 15 years of experience performed the active intervention

By contrast, the sham therapy used a detuned ultrasound device, and the patient was unaware that the ultrasound device was inactivated.

Active exercises were used in both groups and included pelvic tilt and low back lateral flexion exercises that were performed with the patient in the supine position. The participants also engaged in stretching, motor control, and strengthening exercises during the 8 weeks of sessions.

"This study confirmed the immediate analgesic effect of [spinal manipulation/mobilization] over [sham therapy]," the study authors note. "Followed by specific active exercises, [spinal manipulation/mobilization] reduces significantly functional disability and tends to induce a larger decrease in pain intensity, compared to a control group," they add and it confirms the clinical relevance of spinal manipulation/mobilization as an "appropriate treatment" of chronic nonspecific low back pain.

BMC Musculoskelet Disord. Published online August 28, 2012.