Low back pain medical care good if chiropractic by chiropractors added

An investigation of the burden of all diseases in Australia in 2003 found back pain to be among the top 20 burden-imposing diseases in terms of disability-adjusted life-years.(1) A more recent study in 2012 ranked it second only to cancer as a leading cause of disease burden in Australasia (2). Lower back pain is on the rise and will affect the majority of Australians at some point in their life.

Within this context, the pressing question becomes what do you do about it? Until recently, the common protocol for lower back pain was to prescribe paracetamol. However, recent findings indicate that paracetamol is no more effective than taking a placebo for lower back pain. Another study conducted recently may help shed some light on what to do.

CHIROPRACTIC CARE ADDED TO STANDARD MEDICAL CARE ACHIEVES BETTER RESULTS THAN ONLY STANDARD MEDICAL CARE FOR LOWER BACK PAIN

This randomised controlled trial aimed to compare pain levels and physical functioning in patients suffering lower back pain who received standard medical treatment versus patients who also received chiropractic adjustments on top of their standard medical care.

The Standard care group received any or all of the following:

  • History taken and physical examination performed
  • Diagnostic imaging as indicated
  • Education about self-managing their condition, including maintaining activity levels as tolerated
  • Management of condition with pharmacological products, including analgesics and anti-inflammatory agents
  • Physical therapy and modalities e.g. heat and ice
  • Referral to a pain clinic

The remaining patients received a combination of standard medical care plus chiropractic manipulation, which meant they received any or all of the above, as well as:

  • High velocity, low amplitude (HVLA) manipulative therapy from a chiropractor
  • Complimentary treatments as required such as brief massage, stretching instruction and McKenzie exercises.

After 4 weeks, the study found that while both groups had improved, the group that received chiropractic care on top of their standard medical care experienced significantly better results (72% rated their global improvement as "pain completely gone") than the patients who received standard medical care alone (17% rated their global improvement as "pain completely gone"). The results suggest that chiropractic manipulative therapy in conjunction with standard medical care “offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard care” for people suffering from lower back pain.

Perhaps a future study that could be interesting to see would be comparing this type of treatment with patients receiving chiropractic treatment alone for lower back pain.

 

(1). Australian Institute of Health and Welfare. Australia’s health 2006. The tenth biennial health report of the Australian Institute of Health and Welfare. Canberra: AIHW, 2006. (AIHW Cat. No. AUS

(2) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990—2010: a systematic analysis for the Global Burden of Disease Study 2010, The Lancet, Volume 380, Issue 9859, Pages 2224 - 2260, 15 December 2012, doi:10.1016/S0140-6736(12)61766-8

(3) Goertz CM, Long CR, Hondras MA, Petri R, Delgado R, Lawrence DJ, Owens EF, Meeker W (2013) Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: results of a pragmatic randomized comparative effectiveness study. Spine (Phila Pa 1976) 2013 Apr 15;38(8):627-34C.

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