Abstract
Background
The adult lifetime incidence for low back pain is 75% to 85% in the United States.
Investigating appropriate care has proven difficult, since, in general, acute pain
subsides spontaneously and chronic pain is resistant to intervention. Subacute back
pain has been rarely studied.
Objective
To compare the relative efficacy of chiropractic adjustments with muscle relaxants
and placebo/sham for subacute low back pain.
Design
A randomized, double-blind clinical trial.
Methods
Subjects (N = 192) experiencing low back pain of 2 to 6 weeks' duration were randomly
allocated to 3 groups with interventions applied over 2 weeks. Interventions were
either chiropractic adjustments with placebo medicine, muscle relaxants with sham
adjustments, or placebo medicine with sham adjustments. Visual Analog Scale for Pain,
Oswestry Disability Questionnaire, and Modified Zung Depression Scale were assessed
at baseline, 2 weeks, and 4 weeks. Schober's flexibility test, acetaminophen usage,
and Global Impression of Severity Scale (GIS), a physician's clinical impression used
as a secondary outcome, were assessed at baseline and 2 weeks.
Results
Baseline values, except GIS, were similar for all groups. When all subjects completing
the protocol were combined (N = 146), the data revealed pain, disability, depression,
and GIS decreased significantly (P < .0001); lumbar flexibility did not change. Statistical differences across groups
were seen for pain, a primary outcome, (chiropractic group improved more than control
group) and GIS (chiropractic group improved more than other groups). No significant
differences were seen for disability, depression, flexibility, or acetaminophen usage
across groups.
Conclusion
Chiropractic was more beneficial than placebo in reducing pain and more beneficial
than either placebo or muscle relaxants in reducing GIS.
Keywords
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Article info
Publication history
Received in revised form:
May 3,
2002
Received:
February 25,
2002
Footnotes
☆This project was funded by and performed at the Research Center of Life University.
Identification
Copyright
© 2004 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.
