Institutional members access full text with Ovid®

Share this article on:

Does Maintained Spinal Manipulation Therapy for Chronic Nonspecific Low Back Pain Result in Better Long-Term Outcome?

Senna, Mohammed K. MD; Machaly, Shereen A. MD

doi: 10.1097/BRS.0b013e3181f5dfe0
Randomized Trial
Blog

Study Design. A prospective single blinded placebo controlled study was conducted.

Objective. To assess the effectiveness of spinal manipulation therapy (SMT) for the management of chronic nonspecific low back pain (LBP) and to determine the effectiveness of maintenance SMT in long-term reduction of pain and disability levels associated with chronic low back conditions after an initial phase of treatments.

Summary of Background Data. SMT is a common treatment option for LBP. Numerous clinical trials have attempted to evaluate its effectiveness for different subgroups of acute and chronic LBP but the efficacy of maintenance SMT in chronic nonspecific LBP has not been studied.

Methods. Sixty patients, with chronic, nonspecific LBP lasting at least 6 months, were randomized to receive either (1) 12 treatments of sham SMT over a 1-month period, (2) 12 treatments, consisting of SMT over a 1-month period, but no treatments for the subsequent 9 months, or (3) 12 treatments over a 1-month period, along with “maintenance spinal manipulation” every 2 weeks for the following 9 months. To determine any difference among therapies, we measured pain and disability scores, generic health status, and back-specific patient satisfaction at baseline and at 1-, 4-, 7-, and 10-month intervals.

Results. Patients in second and third groups experienced significantly lower pain and disability scores than first group at the end of 1-month period (P = 0.0027 and 0.0029, respectively). However, only the third group that was given spinal manipulations (SM) during the follow-up period showed more improvement in pain and disability scores at the 10-month evaluation. In the nonmaintained SMT group, however, the mean pain and disability scores returned back near to their pretreatment level.

Conclusion. SMT is effective for the treatment of chronic nonspecific LBP. To obtain long-term benefit, this study suggests maintenance SM after the initial intensive manipulative therapy.

This study was conducted to assess the effectiveness of maintenance SMT in long-term reduction of pain and disability associated with chronic low back conditions after an initial phase of treatments. To obtain long-term benefit, this study suggests maintenance SM after the initial intensive manipulative therapy.

From the Rheumatology and Rehabilitation Department, Mansoura Faculty of Medicine, Mansoura University, Egypt

Address correspondence and reprint requests to Shereen A. Machaly, MD, Rheumatology and Rehabilitation Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt; E-mail: shmach_237@hotmail.com.

Acknowledgment date: November 14, 2009. First revision date: March 10, 2010. Second revision date: May 20, 2010. Third revision date: July 11, 2010. Fourth revision date: July 26, 2010. Acceptance date: July 26, 2010.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

© 2011 Lippincott Williams & Wilkins, Inc.