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Daily Archives: October 29, 2013

Dose-response and Efficacy of Spinal Manipulation for Care of Chronic Low Back Pain: A Randomized Controlled Trial

By |October 29, 2013|Chiropractic Care, Low Back Pain|

Dose-response and Efficacy of Spinal Manipulation for Care of Chronic Low Back Pain: A Randomized Controlled Trial

The Chiro.Org Blog


SOURCE:   Spine J. 2013 Oct 16. [Epub ahead of print]

Mitchell Haas, DC, Darcy Vavrek, ND, David Peterson, DC,
Nayak Polissar, PhD, Moni B. Neradilek, MS

Center for Outcomes Studies,
University of Western States,
2700 NE 132nd Ave., Portland, OR 97230, USA.
haasmitch@comcast.net


BACKGROUND CONTEXT:   There have been no full-scale trials of the optimal number of visits for the care of any condition with spinal manipulation.

PURPOSE:   To identify the dose-response relationship between visits to a chiropractor for spinal manipulation and chronic low back pain (cLBP) outcomes and to determine the efficacy of manipulation by comparison with a light massage control.

STUDY DESIGN/SETTING:   Practice-based randomized controlled trial.

PATIENT SAMPLE:   Four hundred participants with cLBP.

OUTCOME MEASURES:   The primary cLBP outcomes were the 100-point modified Von Korff pain intensity and functional disability scales evaluated at the 12- and 24-week primary end points. Secondary outcomes included days with pain and functional disability, pain unpleasantness, global perceived improvement, medication use, and general health status.

METHODS:   One hundred participants with cLBP were randomized to each of four dose levels of care: 0, 6, 12, or 18 sessions of spinal manipulation from a chiropractor. Participants were treated three times per week for 6 weeks. At sessions when manipulation was not assigned, they received a focused light massage control. Covariate-adjusted linear dose effects and comparisons with the no-manipulation control group were evaluated at 6, 12, 18, 24, 39, and 52 weeks.

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