A comparison of spinal manipulation with physical therapy for treatment of patients with mechanical low back pain

Abstract

Background and Objective: With regard to high prevalence of mechanical low back pain (LBP) and its increasing in society and known treatment of physical therapy and also previous successes of spinal manipulation, this study was carried out to compare spinal manipulation and physical therapy for treatment of mechanical LBP in patients who referred to Shohada-e-Tajrish hospital during 2001. Methods: This single blind clinical study was performed on 105 patients (20-60 years old) with LBP for 2 weeks to 6 months and with normal lumbosacral radiography. Pregnant patients, opiate addicts, patients with physical therapy (PT) or spinal manipulation during last six months and those with neurological deficits were excluded from this study. Patients were randomly divided into three groups. An educational pamphlet was given to control group, PT group was treated with hot pack, ultrasound and ordinary TENS and manipulation group was treated with spinal manipulation (Maigne technique). Roland-Morris questionnaire, a visual-analogue pain scale (VAS) and measurement of lumbar spine were used to determine the efficacy of treatment during a 6-week period. Findings: 96 patients (56 females and 40 males) were studied. All groups were similar according to age, sex, BMI, severity of LBP and disability. Severity of LBP and disability were decreased in all groups. Decrease of LBP severity in manipulation group in comparison to two other groups was more (P<0.001). Conclusion: Spinal manipulation was more effective than PT and educational pamphlet for treatment of mechanical LBP. For overcoming with Novelty effect, another study with higher sample size and at least for a 6 month follow up is recommended.

Keywords

• mechanical lbp
• spinal manipulation
• physical therapy