SPINE August 15, 2011; Volume 36, Number 18, pp. 1427 1437 Nonspecific chronic low back pain (LBP) is not attributable to a recognizable, known specific pathology (such as infection, tumor, osteoporosis, fracture, structural deformity, inflammatory disorder, radicular syndrome, or cauda equina syndrome). It represents about 85% of LBP patients seen in primary care. "About 10% [of these patients] will go on to develop chronic, disabling LBP." using the majority of healthcare and sociocconomic costs. This prospective single-blinded placebo-controlled study was conducted to assess the effectiveness of spinal manipulation therapy (SMT) for the management of chronic, nonspecific low back pain (LBP) and to determine the effectiveness of maintenance SMT in long-term reduction of pain and disability levels associated with chronic low back conditions. The spinal manipulation was defined as a "high velocity thrust to a joint beyond its restricted range of movement." Sixty patients with chronic, nonspecific LBP lasting at least six months were randomized to receive either: A)) 12 treatments of sham SMT over a one-month period B)) 12 treatments consisting of SMT over a one-month period C)) 12 SMT treatments over a one month period plus maintenance SMTevcry two weeks for the follow ing nine months. Follow-up evaluations occurred at one. four, seven, and 10 months, and included: A)) Pain (visual analog scale |VAS|) B)) Disability (Oswcstry Disability Questionnaire) Although sham-manipulation patients did show improvement in their back pain, real spinal manipulation was superior in all measured outcomes. Importantly, only the group given maintenance spinal manipulations (even-other week for nine months) showed important improvement in pain and disability scores at the 10-month evaluation. These authors concluded: "This study confirms previous reports show ing that SMT is an effective modality in chronic nonspecific LBP." "To obtain long-term benefit, this study suggests maintenance SMT after the initial intensive manipulative." Pain (VAS) For The Three Groups Over 10 Months Disability (Oswcstry) For The Three Groups Over 10 Months Dr. Dan Murphy graduated mag-na cum laude from Western States Chiropractic College in 1978. He received Diplomat stains in Chiropractic Orthopedics in 1986. Since 1982, Dr. Murphy has served part-time as undergraduate faculty at Life Chiropractic College West, currently teaching classes to seniors in the management of spinal disorders. He has taught more than 2000 postgraduate continuing education seminars. Dr. Murphy is a contributing author to both editions of the book Motor I ehicle Collision Injuries and to the book Pedialric Chiropractic. Hundreds of detailed Article Reviews, pertinent to chiropractors and their patients, are available at Dr. Murphy s web page: www.danmurphydc.com
