Spinal Manipulation Unlikely to Curb Low Back Pain

August 24, 2009
ABC News
Reuters Health

For people who suffer from acute low back pain, adding chiropractic spinal adjustments to standard care — such as following your doctor’s advice on managing pain and taking painkillers — does not appear to generate a greater early reduction in pain compared with standard care alone, according to a Swiss study.

The value of adding spinal manipulation to other treatments for acute low back pain is unclear, Dr. Peter Juni, of the University of Bern, Switzerland, and colleagues note in a report published this month.

In their study, the investigators randomly assigned 104 adults with acute low back pain to spinal manipulation plus standard care or standard care alone. Standard care in this study consisted of general advice and the pain medicines paracetamol (acetaminophen), diclofenac, or dihydrocodeine, as needed. There were 52 patients in each group.

According to Juni and colleagues, reductions in pain, based on a standard pain scale, were similar in both groups, “excluding a relevant benefit” of spinal manipulation.

“While we cannot exclude that specific subgroups of patients with acute low back pain will benefit from adding (spinal manipulation) to standard care, we believe that….our trial provide(s) reliable evidence that the majority of patients with acute low back pain can be effectively treated without (spinal manipulation),” they conclude. More…