title: Manipulative therapy and/or NSAIDs for acute low back pain: design of a randomized controlled trial [ACTRN012605000036617].
abstract: BACKGROUND
  Acute low back pain is a common condition resulting in pain and disability. Current national and international guidelines advocate general practitioner care including advice and paracetamol (4 g daily in otherwise well adults) as the first line of care for people with acute low back pain. Non-steroidal anti-inflammatory drugs (NSAIDs) and spinal manipulative therapy (SMT) are advocated in many guidelines as second line management options for patients with acute low back pain who are not recovering. No studies have explored the role of NSAIDs and/or SMT in addition to first line management for acute low back pain. The primary aim of this study is to investigate if NSAIDs and/or SMT in addition to general practitioner advice and paracetamol results in shorter recovery times for patients with acute low back pain. The secondary aims of the study are to evaluate whether the addition of SMT and/or NSAIDs influences pain, disability and global perceived effect at 1, 2, 4 and 12 weeks after onset of therapy for patients with significant acute low back pain.
  
  
  METHODS
  This paper presents the rationale and design of a randomised controlled trial examining the addition of NSAIDs and/or SMT in 240 people who present to their general practitioner with significant acute low back pain.
authors.affiliation: Back Pain Research Group, University of Sydney, PO Box 170, Lidcombe, NSW, 1825, Australia. M.Hancock@fhs.usyd.edu.au
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Hancock
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Maher
authors.forename: Jane
authors.initials: J
authors.lastname: Latimer
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: McLachlan
authors.forename: Chris W
authors.initials: CW
authors.lastname: Cooper
authors.forename: Richard O
authors.initials: RO
authors.lastname: Day
authors.forename: Megan F
authors.initials: MF
authors.lastname: Spindler
authors.forename: James H
authors.initials: JH
authors.lastname: McAuley
mesh_terms: D000208:Acute Disease; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy / Q000628:therapy*; D020393:Manipulation, Spinal; D012107:Research Design
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal