Adding chiropractic to standard medical therapy for nonspecific low back pain

Christine M Goertz, Cynthia R Long, Maria Hondras, Dana J Lawrence, William C Meeker

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Study Design. Randomized controlled trial.Objective. To assess changes in pain levels and physical functioning in response to standard medical care (SMC) versus SMC plus chiropractic manipulative therapy (CMT) for the treatment of low back pain (LBP) among 18 to 35-year-old active-duty military personnel.Summary of Background Data. LBP is common, costly, and a significant cause of long-term sick leave and work loss. Many different interventions are available, but there exists no consensus on the best approach. One intervention often used is manipulative therapy. Current evidence from randomized controlled trials demonstrates that manipulative therapy may be as effective as other conservative treatments of LBP, but its appropriate role in the healthcare delivery system has not been established.Methods. Prospective, 2-arm randomized controlled trial pilot study comparing SMC plus CMT with only SMC. The primary outcome measures were changes in back-related pain on the numerical rating scale and physical functioning at 4 weeks on the Roland-Morris Disability Questionnaire and back pain functional scale (BPFS).Results. Mean Roland-Morris Disability Questionnaire scores decreased in both groups during the course of the study, but adjusted mean scores were significantly better in the SMC plus CMT group than in the SMC group at both week 2 ( P < 0.001) and week 4 ( P = 0.004). Mean numerical rating scale pain scores were also signifi cantly better in the group that received CMT. Adjustedmean back pain functional scale scores were signifi cantly higher (improved) in the SMC plus CMT group than in the SMC group at both week 2 ( P < 0.001) and week 4 ( P = 0.004).Conclusion. The results of this trial suggest that CMT in conjunction with SMC offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard care, for men and women between 18 and 35 years of age with acute LBP.
Original languageEnglish
JournalSpine
Volume38
Issue number8
Pages (from-to)627-34
ISSN0362-2436
DOIs
Publication statusPublished - 2013

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Chiropractic
Low Back Pain
Randomized Controlled Trials
Delivery of Health Care
Sick Leave
Military Personnel
Consensus
Outcome Assessment (Health Care)

Cite this

Goertz, C. M., Long, C. R., Hondras, M., Lawrence, D. J., & Meeker, W. C. (2013). Adding chiropractic to standard medical therapy for nonspecific low back pain. Spine, 38(8), 627-34. https://doi.org/10.1097/BRS.0b013e31827733e7
Goertz, Christine M ; Long, Cynthia R ; Hondras, Maria ; Lawrence, Dana J ; Meeker, William C. / Adding chiropractic to standard medical therapy for nonspecific low back pain. In: Spine. 2013 ; Vol. 38, No. 8. pp. 627-34.
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abstract = "Study Design. Randomized controlled trial.Objective. To assess changes in pain levels and physical functioning in response to standard medical care (SMC) versus SMC plus chiropractic manipulative therapy (CMT) for the treatment of low back pain (LBP) among 18 to 35-year-old active-duty military personnel.Summary of Background Data. LBP is common, costly, and a significant cause of long-term sick leave and work loss. Many different interventions are available, but there exists no consensus on the best approach. One intervention often used is manipulative therapy. Current evidence from randomized controlled trials demonstrates that manipulative therapy may be as effective as other conservative treatments of LBP, but its appropriate role in the healthcare delivery system has not been established.Methods. Prospective, 2-arm randomized controlled trial pilot study comparing SMC plus CMT with only SMC. The primary outcome measures were changes in back-related pain on the numerical rating scale and physical functioning at 4 weeks on the Roland-Morris Disability Questionnaire and back pain functional scale (BPFS).Results. Mean Roland-Morris Disability Questionnaire scores decreased in both groups during the course of the study, but adjusted mean scores were significantly better in the SMC plus CMT group than in the SMC group at both week 2 ( P < 0.001) and week 4 ( P = 0.004). Mean numerical rating scale pain scores were also signifi cantly better in the group that received CMT. Adjustedmean back pain functional scale scores were signifi cantly higher (improved) in the SMC plus CMT group than in the SMC group at both week 2 ( P < 0.001) and week 4 ( P = 0.004).Conclusion. The results of this trial suggest that CMT in conjunction with SMC offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard care, for men and women between 18 and 35 years of age with acute LBP.",
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Goertz, CM, Long, CR, Hondras, M, Lawrence, DJ & Meeker, WC 2013, 'Adding chiropractic to standard medical therapy for nonspecific low back pain', Spine, vol. 38, no. 8, pp. 627-34. https://doi.org/10.1097/BRS.0b013e31827733e7

Adding chiropractic to standard medical therapy for nonspecific low back pain. / Goertz, Christine M; Long, Cynthia R; Hondras, Maria ; Lawrence, Dana J; Meeker, William C.

In: Spine, Vol. 38, No. 8, 2013, p. 627-34.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Adding chiropractic to standard medical therapy for nonspecific low back pain

AU - Goertz, Christine M

AU - Long, Cynthia R

AU - Hondras, Maria

AU - Lawrence, Dana J

AU - Meeker, William C

PY - 2013

Y1 - 2013

N2 - Study Design. Randomized controlled trial.Objective. To assess changes in pain levels and physical functioning in response to standard medical care (SMC) versus SMC plus chiropractic manipulative therapy (CMT) for the treatment of low back pain (LBP) among 18 to 35-year-old active-duty military personnel.Summary of Background Data. LBP is common, costly, and a significant cause of long-term sick leave and work loss. Many different interventions are available, but there exists no consensus on the best approach. One intervention often used is manipulative therapy. Current evidence from randomized controlled trials demonstrates that manipulative therapy may be as effective as other conservative treatments of LBP, but its appropriate role in the healthcare delivery system has not been established.Methods. Prospective, 2-arm randomized controlled trial pilot study comparing SMC plus CMT with only SMC. The primary outcome measures were changes in back-related pain on the numerical rating scale and physical functioning at 4 weeks on the Roland-Morris Disability Questionnaire and back pain functional scale (BPFS).Results. Mean Roland-Morris Disability Questionnaire scores decreased in both groups during the course of the study, but adjusted mean scores were significantly better in the SMC plus CMT group than in the SMC group at both week 2 ( P < 0.001) and week 4 ( P = 0.004). Mean numerical rating scale pain scores were also signifi cantly better in the group that received CMT. Adjustedmean back pain functional scale scores were signifi cantly higher (improved) in the SMC plus CMT group than in the SMC group at both week 2 ( P < 0.001) and week 4 ( P = 0.004).Conclusion. The results of this trial suggest that CMT in conjunction with SMC offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard care, for men and women between 18 and 35 years of age with acute LBP.

AB - Study Design. Randomized controlled trial.Objective. To assess changes in pain levels and physical functioning in response to standard medical care (SMC) versus SMC plus chiropractic manipulative therapy (CMT) for the treatment of low back pain (LBP) among 18 to 35-year-old active-duty military personnel.Summary of Background Data. LBP is common, costly, and a significant cause of long-term sick leave and work loss. Many different interventions are available, but there exists no consensus on the best approach. One intervention often used is manipulative therapy. Current evidence from randomized controlled trials demonstrates that manipulative therapy may be as effective as other conservative treatments of LBP, but its appropriate role in the healthcare delivery system has not been established.Methods. Prospective, 2-arm randomized controlled trial pilot study comparing SMC plus CMT with only SMC. The primary outcome measures were changes in back-related pain on the numerical rating scale and physical functioning at 4 weeks on the Roland-Morris Disability Questionnaire and back pain functional scale (BPFS).Results. Mean Roland-Morris Disability Questionnaire scores decreased in both groups during the course of the study, but adjusted mean scores were significantly better in the SMC plus CMT group than in the SMC group at both week 2 ( P < 0.001) and week 4 ( P = 0.004). Mean numerical rating scale pain scores were also signifi cantly better in the group that received CMT. Adjustedmean back pain functional scale scores were signifi cantly higher (improved) in the SMC plus CMT group than in the SMC group at both week 2 ( P < 0.001) and week 4 ( P = 0.004).Conclusion. The results of this trial suggest that CMT in conjunction with SMC offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard care, for men and women between 18 and 35 years of age with acute LBP.

U2 - 10.1097/BRS.0b013e31827733e7

DO - 10.1097/BRS.0b013e31827733e7

M3 - Journal article

C2 - 24509557

VL - 38

SP - 627

EP - 634

JO - Spine

JF - Spine

SN - 0362-2436

IS - 8

ER -