Effectiveness of four conservative treatments for subacute low back pain: a randomized clinical trial.
METHODS
A randomized, assessor-blinded clinical trial was conducted.


OBJECTIVE
To investigate the relative effectiveness of three manual treatments and back school for patients with subacute low back pain.


BACKGROUND
Literature comparing the relative effectiveness of specific therapies for low back pain is limited.


METHODS
Among the 5925 inquiries, 206 patients met the specific admission criteria, and 200 patients randomly received one of four treatments for 3 weeks: back school, joint manipulation, myofascial therapy, and combined joint manipulation and myofascial therapy. These patients received assessments at baseline, after 3 weeks of therapy, and 6 months after the completion of therapy. The primary outcomes were evaluated using visual analog pain scales and Roland-Morris activity scales.


RESULTS
All four groups showed significant improvement in pain and activity scores after 3 weeks of care, but did not show further significant improvement at the 6-month follow-up assessment. No statistically significant between-group differences were found either at the 3-week or 6-month reassessments.


CONCLUSIONS
For subacute low back pain, combined joint manipulation and myofascial therapy was as effective as joint manipulation or myofascial therapy alone. Additionally, back school was as effective as three manual treatments.
Hsieh
Chang-Yu J
CY
Research Division; and Professional Affairs, Los Angeles College of Chiropractic, Southern California University of Health Sciences, Whittier, California, USA. jhsieh@ix.netcom.com
Adams
Alan H
AH
Tobis
Jerome
J
Hong
Chang-Zern
CZ
Danielson
Clark
C
Platt
Katherine
K
Hoehler
Fred
F
Reinsch
Sibylle
S
Rubel
Arthur
A
D000554:Ambulatory Care Facilities; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000150:complications / Q000628:therapy*; D008161:Lumbosacral Region; D008297:Male; D020393:Manipulation, Spinal; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000150:complications / Q000175:diagnosis; D010147:Pain Measurement; D010349:Patient Compliance; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities / Q000379:methods*; D016896:Treatment Outcome