title: The effectiveness of manual therapy, physiotherapy, and treatment by the general practitioner for nonspecific back and neck complaints. A randomized clinical trial.
abstract: In a randomized trial, the effectiveness of manual therapy, physiotherapy, continued treatment by the general practitioner, and placebo therapy (detuned ultrasound and detuned short-wave diathermy) were compared for patients (n = 256) with nonspecific back and neck complaints lasting for at least 6 weeks. The principle outcome measures were severity of the main complaint, global perceived effect, pain, and functional status. These are presented for 3, 6, and 12 weeks follow-up. Both physiotherapy and manual therapy decreased the severity of complaints more and had a higher global perceived effect compared to continued treatment by the general practitioner. Differences in effectiveness between physiotherapy and manual therapy could not be shown. A substantial part of the effect of manual therapy and physiotherapy appeared to be due to nonspecific (placebo) effects.
authors.affiliation: Department of Epidemiology and Biostatistics, University of Limburg, Maastricht, The Netherlands.
authors.forename: B W
authors.initials: BW
authors.lastname: Koes
authors.forename: L M
authors.initials: LM
authors.lastname: Bouter
authors.forename: H
authors.initials: H
authors.lastname: van Mameren
authors.forename: A H
authors.initials: AH
authors.lastname: Essers
authors.forename: G M
authors.initials: GM
authors.lastname: Verstegen
authors.forename: D M
authors.initials: DM
authors.lastname: Hofhuizen
authors.forename: J P
authors.initials: JP
authors.lastname: Houben
authors.forename: P G
authors.initials: PG
authors.lastname: Knipschild
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001416:Back Pain / Q000453:epidemiology / Q000534:rehabilitation*; D003972:Diathermy; D005260:Female; D006801:Humans; D008297:Male; D008349:Manipulation, Orthopedic; D008405:Massage; D009333:Neck; D026741:Physical Therapy Modalities; D015990:Placebo Effect; D014464:Ultrasonic Therapy
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal