title: Efficacy of preventive spinal manipulation for chronic low-back pain and related disabilities: a preliminary study.
abstract: OBJECTIVE
  To document the potential role of maintenance chiropractic spinal manipulation to reduce overall pain and disability levels associated with chronic low-back conditions after an initial phase of intensive chiropractic treatments.
  
  
  METHODS
  Thirty patients with chronic nonspecific low-back pain were separated into 2 groups. The first group received 12 treatments in an intensive 1-month period but received no treatment in a subsequent 9-month period. For this group, a 4-week period preceding the initial phase of treatment was used as a control period to examine the sole effect of time on pain and disability levels. The second group received 12 treatments in an intensive 1-month period and also received maintenance spinal manipulation every 3 weeks for a 9-month follow-up period. Pain and disability levels were evaluated with a visual analog scale and a modified Oswestry questionnaire, respectively.
  
  
  RESULTS
  The 1-month control period did not modify the pain and disability levels. For both groups, the pain and disability levels decreased after the intensive phase of treatments. Both groups maintained their pain scores at levels similar to the postintensive treatments throughout the follow-up period. For the disability scores, however, only the group that was given spinal manipulations during the follow-up period maintained their postintensive treatment scores. The disability scores of the other group went back to their pretreatment levels.
  
  
  CONCLUSIONS
  Intensive spinal manipulation is effective for the treatment of chronic low back pain. This experiment suggests that maintenance spinal manipulations after intensive manipulative care may be beneficial to patients to maintain subjective postintensive treatment disability levels. Future studies, however, are needed to confirm the finding in a larger group of patients with chronic low-back pain.
authors.affiliation: Laval University, Kinesiology Division and Quebec University in Trois-Rivières, Chiropractic Department, Quebec, Canada. Martin_descarreaux@uqtr.ca <Martin_descarreaux@uqtr.ca>
authors.forename: Martin
authors.initials: M
authors.lastname: Descarreaux
authors.forename: Jean-Sébastien
authors.initials: JS
authors.lastname: Blouin
authors.forename: Marc
authors.initials: M
authors.lastname: Drolet
authors.forename: Stanislas
authors.initials: S
authors.lastname: Papadimitriou
authors.forename: Normand
authors.initials: N
authors.lastname: Teasdale
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000150:complications / Q000517:prevention & control*; D008297:Male; D026882:Manipulation, Chiropractic