Review of “Adding Chiropractic Manipulative Therapy to Standard Medical Care for Patients with Acute Low Back Pain: The Results of a Pragmatic Randomized Comparative Effectiveness Study SPINE Volume 38, Number 8: 627–634 2013”
Standard Medical Care (SMC) combined with Chiropractic Care (CMT) provides clear advantages for patients suffering from acute low back pain based on changes in pain levels and physical functioning (numerical rating scale and physical functioning at 4 weeks on the Roland-Morris Disability Questionnaire and back pain functional scale (BPFS)) in 18 to 35-year-old active-duty military personnel.
Roland-Morris Disability Questionnaire scores decreased in both groups, but
adjusted mean scores were best in the combined (SMC plus CMT) group
Conclusion. The results of this trial suggest that CMT in conjunction with SMC offers a significant advantage for decreasing pain and improving physical functioning and average satisfaction with “overall results of care” was 8.9/10. Working together through interdisciplinary care seems to not only yield better outcomes, but also greater satisfaction for the patients which we serve.
“Standard care included any or all of the following: a focused history and physical examination, diagnostic imaging as indicated, education about self-management including maintaining activity levels as tolerated, pharmacological management with the use of analgesics and anti-infl ammatory agents, and physical therapy and modalities such as heat/ice and referral.”
“Chiropractic Manipulative Therapy patients were scheduled for up to 2 visits weekly with a doctor of chiropractic (DC) for a period of 4 weeks. The initial visit with the DC included a focused history and physical examination and diagnostic imaging as indicated. Treatments consisted of HVLA manipulation as the primary approach in all cases, with ancillary treatments at the doctor’s discretion, including brief massage, the use of ice or heat in the lumbar area, stretching exercises, McKenzie exercises, advice on activities of daily living, postural/ergonomic advice; and mobilization.”
It is possible that the military population was also more physically fit than the general population or previous study populations that evaluated CMT for LBP.
It was found that “there was a statistically and clinically significant benefit to those patients receiving chiropractic manipulative treatment…” “The majority of systematic reviews find that chiropractic manipulative therapy appears to reduce pain and disability at least moderately for many low back pain patients.” “73% of participants in the SMC plus CMT group rated their global improvement as pain completely gone, much better, or moderately better, compared with 17% in the SMC group.”
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References
1. Hart LG , Deyo RA , Cherkin DC , et al. Physician offi ce visits for
low back pain. Frequency, clinical evaluation, and treatment patterns
from a U.S. national survey . Spine (Phila Pa 1976) 1995 ; 20 :
11–9 .
2. Andersson GB . Epidemiology of low back pain . Acta Orthop Scand
Suppl 1998 ; 281 : 28–31 .
3. Maniadakis N , Gray A . The economic burden of back pain in the
UK . Pain 2000 ; 84 : 95–103 .
4. Macfarlane GJ , Beasley M , Jones EA , et al. The prevalence and
management of low back pain across adulthood: results from a
population-based cross-sectional study (the MUSICIAN study) .
Pain 2012 ; 153 : 27–32 .
5. Dagenais S , Caro J , Haldeman S . A systematic review of low back
pain cost of illness studies in the United States and internationally .
Spine J 2008 ; 8 : 8–20 .
6. Walker BF . The prevalence of low back pain: a systematic review
of the literature from 1966 to 1998 . J Spinal Disord 2000 ; 13 :
205–217 .
7. Barnes PM , Powell-Griner E , McFann K , et al. Complementary and
alternative medicine use among adults: United States, 2002 . Adv
Data 2004 ; 1–19 .
8. Barnes PM , Bloom B , Nahin RL . Complementary and alternative
medicine use among adults and children: United States, 2007 . Natl
Health Stat Rep 2008 ; 1–23 .
9. Assendelft WJ , Morton SC , Yu EI , et al. Spinal manipulative therapy
for low back pain. A meta-analysis of effectiveness relative to
other therapies . Ann Intern Med 2003 ; 138 : 871–81 .
10. Lawrence DJ , Meeker W , Branson R , et al. Chiropractic management
of low back pain and low back-related leg complaints:
a literature synthesis . J Manipulative Physiol Ther 2008 ; 31 :
659–74 .
11. Bronfort G , Haas M , Evans R , et al. Evidence-informed management
of chronic low back pain with spinal manipulation and
mobilization . Spine J 2008 ; 8 : 213–25 .
Originally published on Medium