Low back pain of mechanical origin: randomised comparison of chiropractic and hospital outpatient treatment.

Meade, T. W.; Dyer, Sandra; Browne, Wendy; Townsend, Joy; Frank, Andrew

doi:10.1136/bmj.300.6737.1431

Cited by 379 publications

(108 citation statements)

References 6 publications

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“…In another study, continuing ordinary activities within the limits of pain led to more rapid recovery than either bed rest or back-mobilising exercises [17]. Another comparison showed that chiropractic treatment was more effective than hospital outpatient treatment, mainly in chronic or severe back pain [18]. In one study by Faas et al [12], exercise therapy for patients with acute low-back pain gave no advantage over general practitioner care.…”

Section: Introductionmentioning

confidence: 99%

Conservative treatment in patients sick-listed for acute low-back pain: a prospective randomised study with 12 months' follow-up

Seferlis

Németh

Carlsson

et al. 1998

European Spine Journal

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We evaluated three different conservative treatment methods for acute low-back pain patients in groups following a manual therapy programme, an intensive training programme, or a general practitioner programme, the latter serving as the control group. Patients aged 19-64 years on sick leave for low-back pain with or without sciatica were included in a prospective randomised study evaluating outcomes such as impairment, pain, functional disability, socio-economic disability and satisfaction with the treatment or explanations. Evaluation by unbiased observers was performed at 1, 3 and 12 months. The three treatment groups were comparable at baseline. With regard to satisfaction, the patients in the manual therapy programme and those in the intensive training programme were more satisfied with the treatment than those in the general practitioner programme at all follow-ups. With regard to the explanations of current low-back pain episodes, the patients in the manual therapy programme were more satisfied than those in the general practitioner programme at all follow-ups. The manual therapy programme group were also more satisfied with the explanations than those in the intensive training programme

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Section: Introductionmentioning

confidence: 99%

Conservative treatment in patients sick-listed for acute low-back pain: a prospective randomised study with 12 months' follow-up

Seferlis

Németh

Carlsson

et al. 1998

European Spine Journal

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Section: Physical Interventionsmentioning

confidence: 99%

“…This approach has been shown to be highly effective, both therapeutically and in terms of cost effectiveness [21][22][23]. Other forms of physical modalities for pain management that have been studied and displayed to have some promising results in aiding pain relief include myofascial-release therapy, chiropractic care, and exercise to improve coordination/stabilization, strength/resistance, and cardiovascular training groups [24][25][26].Myofascial-release therapies relieve tension by applying pressure on trigger points (in a massage or reflexology style) by a certified health professional [27,28]. These activities can be self-administered at home with proper materials (foam rollers, massage sticks, balls), and following instruction from one's therapist or health professional [29].…”

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confidence: 99%

The Chronic Low Back Pain Epidemic in Older Adults in America

Bevers¹,

Hulla²,

Rice³

et al. 2017

J Pain Relief

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Chronic low back pain is a debilitating condition affecting millions of Americans annually. Older-adult populations suffer a high prevalence of this continually painful state, and further face a unique set of challenges to manage short-and long-term biopsychosocial functioning. As the population ages, and the proportion of older adults grow, it is essential to explore and develop the most effective interdisciplinary strategies to care for older adults who are chronic pain sufferers. In this Commentary, we highlight some of the special challenges that the older-adult population encounters, and their influence on pain management strategies.Keywords: Low back pain; Chronic pain; Biopsychosocial; America; Older adults CommentaryChronic low back pain (CLBP) is a widely prevalent condition affecting more than 25 million Americans [1]. In a recent 2014 report by the National Health Interview Survey (NHIS), it was noted that low back pain was the most prevalent reported pain site, exceeding joint conditions, headache/migraines, neck, and facial, or jaw pain [2]. Roughly one third (34%) of adults aged 65-74, and adults aged 75 and over (34.9%), reported low back pain in the last 3-months [2]. As the population ages, CLBP reports are expected to rise, further necessitating the need to develop interdisciplinary pain management strategies for this growing part of the population [3].In addition to CLBP, older adult populations often have multiple conditions that can complicate and limit traditional pain management therapies. As a result, they face distinctive challenges regarding healthcare regimens, including adherence, physical ability, psychological and social conditions, age-related mental decline, agerelated physical decline, and pharmacological intake concerns. Furthermore, general physical decline due to aging often limits the patient's ability to participate in physical interventions, such as exercise and more vigorous physical therapies. Often, simple stretching techniques or light exercise may not be a viable option [4]. Additionally, psychosocial status must be evaluated for adherence and well-being. Chronic pain patients often experience depression, anxiety, and sleep disorders [5], as well as dementia, Alzheimer's, and other ailments that can impede proper care.Medications are widely prescribed to help combat pain, particularly when these physical limitations are present. On average, older Americans consume multiple medications daily [6]. The large volume of prescription medication consumption certainly influences the available and appropriate treatment options to both avoid side-effects and maintain good quality-of-life. Considering these astonishing figures, it is vital to develop comprehensive, interdisciplinary preventive measures and pain management strategies in order to account for the unique concerns of the older-adult population. This Commentary aims to highlight some of the special challenges the older-adult population faces, and the importance of implementing interdisciplinary treatment strate...

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“…SMT has been investigated for clinical outcomes and has been established as a clinically effective modality for the treatment of patients with low back pain, neck pain as well as cervicogenic headache and other musculoskeletal disorders (Meade et al, 1990;Shekelle et al, 1992;Koes et al, 1996;Cherkin et al, 1998;Hurwitz et al, 2002;Assendelft et al, 2003;Assendelft et al, 2004). Although research directed towards understanding the mechanisms of SMT has increased dramatically, the most fundamental biomechanical aspects of this intervention are still poorly understood (Maigne & Guillon, 2000;Keller et al, 2003;Maigne & Guillon, 2000;Cramer et al, 2006;Herzog et al, 1993a).…”

Section: Introductionmentioning

confidence: 99%

Acceleration of clinician hand movements during spinal manipulative therapy

Gelley¹,

Passmore

MacNeil

2015

Manual Therapy

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The primary objective of this study was to determine the acceleration characteristics of spinal manipulative therapy (SMT) and whether patient anthropometric parameters correlated with the SMT kinematic parameters. For this, a wireless tri-axial accelerometer was taped to the dorsum of a clinician's hand to record the accelerations generated during clinical treatment of 95 symptomatic patients. Peak acceleration magnitudes differed significantly between spinal levels (p<0.0001; lumbar > cervical > thoracic = sacroiliac). The latencies of these peaks were also significantly different (p<0.0001; lumbar < cervical = thoracic < sacroiliac). Within a given spinal level, acceleration amplitudes varied over a wide range with temporal parameters remaining relatively constant. Overall, anthropometric parameters were poorly correlated with SMT parameters. In summary, distinct acceleration amplitudes were observed across spinal levels with relatively constant temporal factors. Thus, clinicians appear to vary the magnitude rather than the duration of the SMT thrust.ii Acknowledgements

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Low back pain of mechanical origin: randomised comparison of chiropractic and hospital outpatient treatment.

Cited by 379 publications

References 6 publications

Conservative treatment in patients sick-listed for acute low-back pain: a prospective randomised study with 12 months' follow-up

Conservative treatment in patients sick-listed for acute low-back pain: a prospective randomised study with 12 months' follow-up

The Chronic Low Back Pain Epidemic in Older Adults in America

Acceleration of clinician hand movements during spinal manipulative therapy

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