title: Efficacy of treating low back pain and dysfunction secondary to osteoarthritis: chiropractic care compared with moist heat alone.
abstract: OBJECTIVE
  To evaluate the efficacy of chiropractic spinal manipulation, manual flexion/distraction, and hot pack application for the treatment of low back pain from osteoarthritis (OA) compared with moist heat alone.
  
  
  METHODS
  Two hundred fifty-two patients with low back pain secondary to OA were randomly assigned to either the treatment group (moist hot pack plus chiropractic care) or the moist heat group subjects, which attended 20 treatment sessions over several weeks. At sessions 1, 5, 10, 15, and 20, they rated pain using a visual analog pain scale, activities of daily living using the Oswestry Low Back Pain Questionnaire, and a range of motion (ROM) using the J-Tech Dual Digital Inclinometer (JTECH Medical Model no. AA036).
  
  
  RESULTS
  Session I ratings indicated that the two groups were equivalent on all pain and flexion scores. The treatment group reported greater and more rapid pain reduction and greater and more rapid ROM improvement than the moist heat group. The treatment group also had greater improvements than the moist heat group in daily living activities in 4 of the 9 areas measured.
  
  
  CONCLUSIONS
  Chiropractic care combined with heat is more effective than heat alone for treating OA-based lower back pain. Pain reduction occurs more rapidly and to a greater degree, and ROM increases more rapidly and to a greater degree.
authors.affiliation: Community Health Institute, Winchester Hospital, Winchester, Mass 01890, USA.
authors.forename: Kathleen L
authors.initials: KL
authors.lastname: Beyerman
authors.forename: Mark B
authors.initials: MB
authors.lastname: Palmerino
authors.forename: Lee E
authors.initials: LE
authors.lastname: Zohn
authors.forename: Gary M
authors.initials: GM
authors.lastname: Kane
authors.forename: Kathy A
authors.initials: KA
authors.lastname: Foster
mesh_terms: D000203:Activities of Daily Living; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D017116:Low Back Pain / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D026882:Manipulation, Chiropractic; D010003:Osteoarthritis / Q000150:complications*; D016059:Range of Motion, Articular; D016896:Treatment Outcome