The effectiveness of manual therapy, physiotherapy, and treatment by the general practitioner for nonspecific back and neck complaints. A randomized clinical trial.
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.
Koes
B W
BW
Department of Epidemiology and Biostatistics, University of Limburg, Maastricht, The Netherlands.
Bouter
L M
LM
van Mameren
H
H
Essers
A H
AH
Verstegen
G M
GM
Hofhuizen
D M
DM
Houben
J P
JP
Knipschild
P G
PG
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
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal