Maintenance Care for Chronic Low Back Pain

August 5, 2011 » In: Research » Leave a comment

Maintenance Care for Chronic Low Back Pain

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

Spine:
15 August 2011 – Volume 36 – Issue 18 – p 1427–1437
doi: 10.1097/BRS.0b013e3181f5dfe0
Randomized Trial

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.

About the Author:Dr. Trent Artichoker - Denver Chiropractor

Denver chiropractor, Dr. Trent Artichoker MS, DC is the clinical director and founder of Denver Chiropractic, LLC. The clinic is the oldest clinic in Denver, CO located in north west Denver, near downtown. Dr. Artichoker treats car accident injuries, neck pain, whiplash, back pain, and headaces.