Does maintained spinal manipulation therapy for chronic non-specific low back pain result in better long term outcome?

ABSTRACT

To assess the efficacy of spinal manipulation therapy [SMT] for the management of chronic non-specific LBP and to determine the efficacy of maintenance SMT in long-term reduction of pain and disability levels associated with chronic low-back conditions after an initial phase of treatments. 60 patients with chronic, nonspecific low back pain [LBP] lasting at least 6 months were separated into 3 groups. The first group received 12 treatments of sham SMT. The second group received 12 treatments, consisting of SMT over a one-month period, but no treatments for the subsequent nine months. The third group also received 12 treatments over a one-month period, along with [maintenance spinal manipulation] every week for the following nine months. To determine any difference among therapies, we measured pain and disability scores at baseline and at 1-month, 4-month, 7-month and 10-month intervals. Patients in second and third groups experienced significantly lower pain and disability scores than first group at the end of 1-month period [P=0.0027 and 0.0029, respectively]. However, only the third group that was given spinal manipulations during the follow-up period showed more improvement in pain and disability scores at the 10-month evaluation. In the other two groups, however, the mean pain and disability scores returned back near to their pretreatment level. SMT is effective for the treatment of chronic non specific LBP. To obtain long-term benefit, this study suggests maintenance spinal manipulations after the initial intensive manipulative therapy