Spine Manipulation compared to NSAIDS-Spine J Vol 38, No 7 2013

Posted by:  Kevin G. Parker, D.C.


SPINE Volume 38, Number 7, pp 540–548-©2013, Lippincott Williams & Wilkins-spinejournal.com April 2013

Spinal High-Velocity Low Amplitude Manipulation in Acute Nonspecifi c Low Back Pain

A Double-Blinded Randomized Controlled Trial in Comparison With Diclofenac and Placebo

Wolfgang J. von Heymann , Dr. Med ,* Patrick Schloemer , Dipl. Math ,† Juergen Timm , Dr. RER, NAT, PhD ,† and

Bernd Muehlbauer , Dr. Med *-Study Design. A randomized, double-blinded, placebo-controlled, parallel trial with 3 arms.

Conclusion.  In a subgroup of patients with acute nonspecific Low Back Pain, spinal manipulation was significantly better than nonsteroidal antiinflammatory drug diclofenac and clinically superior to placebo.

Objective. To investigate in acute nonspecifi c low back pain (LBP) the effectiveness of spinal high-velocity low-amplitude (HVLA) manipulation compared with the nonsteroidal anti-infl ammatory drug diclofenac and with placebo.

Summary of Background Data. LBP is an important economical factor in all industrialized countries. Few studies have evaluated the effectiveness of spinal manipulation in comparison to nonsteroidal anti-infl ammatory drugs or placebo regarding satisfaction and function of the patient, off-work time, and rescue medication.

Methods. A total of 101 patients with acute LBP (for < 48 hr) were recruited from 5 outpatient practices, exclusion criteria were numerous and strict. The subjects were randomized to 3 groups: (1)spinal manipulation and placebo-diclofenac; (2) sham manipulation and diclofenac; (3) sham manipulation and placebo-diclofenac.

Outcomes registered by a second and blinded investigator included self-rated physical disability, function (SF-12), off-work time, and rescue medication between baseline and 12 weeks after randomization.

Results. Thirty-seven subjects received spinal manipulation, 38 diclofenac, and 25 no active treatment. The placebo group with a high number of dropouts for unsustainable pain was closed praecox. Comparing the 2 active arms with the placebo group the intervention groups were signifi cantly superior to the control group.

Low back pain (LBP) is a common problem to medicine and a reasonable threat to all national health care systems.

In 1998, total US health care expenditures for LBP were estimated at $90 billion. 1 Average total health expenditures for patients with back and neck problems increased from $4795 per year in 1997 to about $6096 per year in 2005, an inflation-adjusted increase of 65% (in 2005 US dollars). 2 Low back pain also incurs high indirect costs due to lost productivity.

3 Reducing ineffective treatments 4 is necessary to decrease the LBP associated costs.

The prevalence of LBP is estimated to be between 31% and 47%. 5 – 7 Statistically, women are affected more frequently than men; the level of education is important—patients with less education have a higher risk. 5 Subjects with osteoarthritis, vital exhaustion, depression, fear avoidance, or post-traumatic stress syndrome also seem to be affected more often. 8 – 15 On average, 80% of patients who receive treatment of acute LBP return to work within 1 month, 16 whereas approximately 7% develop chronic LBP. 6 However, those without treatment develop chronic LBP or recurrences in more than 60%. 17

Appropriate treatment therefore seems to be essential to avoid chronic pain.

Because of a multiple pathogenesis, there is not 1 single diagnosis of LBP.

Related articles:

Healing Time of Soft Tissue

Chiropractic Manipulation and Rehabilitation

PAIN-Why Things Hurt-Lorimer Moseley

Why Does Back Pain Recur?

Inflamed gut equals inflamed Joints-Cordain-Br J Nutr. 2000

Fascia-The Secret Life of Fascia-Charles Poliquin blog 2011

Myofascial Release Technique-Active Release Technique (ART)

Muscle Trigger points vs Acupuncture points

Manipulation in Improving Motion and Joint Health ~Review of Medical literature

If you are suffering from: Sports Injuries, Sprains, Strains, Car accident,  Herniated Disc, Disc Bulge, Degenerative Disc Disease, Neck pain, Headaches, Low back pain, of just want to feel better and have better life performance– please call our office in Irvine, California- at 949.857.1888 or visit our website at ADJUST2IT to learn more about Functional Fitness ChiropracticSports massage,Myofascial ReleaseCorrective ExerciseNon Surgical Spinal DecompressionClass IV laser,  and Functional Nutrition.

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