Randomised comparison of chiropractic and hospital outpatient management for low back pain: results from extended follow up.
OBJECTIVE
To compare the effectiveness over three years of chiropractic and hospital outpatient management for low back pain.


METHODS
Randomised allocation of patients to chiropractic or hospital outpatient management.


METHODS
Chiropractic clinics and hospital outpatient departments within reasonable travelling distance of each other in 11 centres.


METHODS
741 men and women aged 18-64 years with low back pain in whom manipulation was not contraindicated.


METHODS
Change in total Oswestry questionnaire score and in score for pain and patient satisfaction with allocated treatment.


RESULTS
According to total Oswestry scores improvement in all patients at three years was about 29% more in those treated by chiropractors than in those treated by the hospitals. The beneficial effect of chiropractic on pain was particularly clear. Those treated by chiropractors had more further treatments for back pain after the completion of trial treatment. Among both those initially referred from chiropractors and from hospitals more rated chiropractic helpful at three years than hospital management.


CONCLUSIONS
At three years the results confirm the findings of an earlier report that when chiropractic or hospital therapists treat patients with low back pain as they would in day to day practice those treated by chiropractic derive more benefit and long term satisfaction than those treated by hospitals.
Meade
T W
TW
Epidemiology and Medical Care Unit, Wolfson Institute of Preventive Medicine, Medical College, St Bartholomew's Hospital, London.
Dyer
S
S
Browne
W
W
Frank
A O
AO
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D002684:Chiropractic; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D012017:Referral and Consultation; D016896:Treatment Outcome