A COMPARISON BETWEEN CHIROPRACTIC MANAGEMENT AND PAIN CLINIC MANAGEMENT FOR CHRONIC LOW-BACK PAIN IN A NATIONAL HEALTH SERVICE OUTPATIENT CLINIC
 
   

A Comparison Between Chiropractic Management and
Pain Clinic Management for Chronic Low-back Pain
in a National Health Service Outpatient Clinic

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:
   Frankp@chiro.org
 
   

FROM:   J Alternative and Complementary Med 2008 (Jun); 14 (5): 465473

Adam Wilkey, Michael Gregory, David Byfield, Peter W. McCarthy

Private Practice, Oldham, United Kingdom


OBJECTIVE:   To compare outcomes in perception of pain and disability for a group of patients suffering with chronic low-back pain (CLBP) when managed in a hospital by either a regional pain clinic or a chiropractor. DESIGN: The study was a pragmatic, randomized, controlled trial.

SETTING:   The trial was performed at a National Health Service (NHS) hospital outpatient clinic (pain clinic) in the United Kingdom.

SUBJECTS AND INTERVENTIONS:   Patients with CLBP (i.e., symptom duration of >12 weeks) referred to a regional pain clinic (outpatient hospital clinic) were assessed and randomized to either chiropractic or pain-clinic management for a period of 8 weeks. The study was pragmatic, allowing for normal treatment protocols to be used. Treatment was administered in an NHS hospital setting.

OUTCOME MEASURES:   The Roland-Morris Disability Questionnaire (RMDQ) and Numerical Rating Scale were used to assess changes in perceived disability and pain. Mean values at weeks 0, 2, 4, 6, and 8 were calculated. The mean differences between week 0 and week 8 were compared across the two treatment groups using Student's t-tests. Ninety-five percent (95%) confidence intervals (CIs) for the differences between groups were calculated.

RESULTS:   Randomization placed 12 patients in the pain clinic and 18 in the chiropractic group, of which 11 and 16, respectively, completed the trial. At 8 weeks, the mean improvement in RMDQ was 5.5 points greater for the chiropractic group (decrease in disability by 5.9) than for the pain-clinic group (0.36) (95% CI 2.0 points to 9.0 points; p = 0.004). Reduction in mean pain intensity at week 8 was 1.8 points greater for the chiropractic group than for the pain-clinic group (p = 0.023).

CONCLUSIONS:   This study suggests that chiropractic management administered in an NHS setting may be effective for reducing levels of disability and perceived pain during the period of treatment for a subpopulation of patients with CLBP.


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