Manual Therapy in Primary Care of Acute Low Back Pain. Abstract, Executive211 Summary and Final Report

摘要

Spinal manipulation is one of the few treatments considered modestly effective211u001efor low back pain, but is rarely performed by MD's. Our specific questions were: 211u001e(1) Can physicians reliably learn the approach to manual therapy, including 211u001espinal manipulation; (2) Can the use of simple spinal manipulation therapy by 211u001eallopathic physicians improve the clinical outcomes of patients with acute low 211u001eback pain. We recruited and trained 33 primary care allopathic physicians on the 211u001ebasics of spinal manipulation for acute low back pain. We enrolled 295 patients 211u001ein a randomized trial in 31 physicians' offices. We compared 'manual therapy,' a 211u001eseries of up to 4 visits which included physician-administered manual therapy, 211u001ewith 'enhanced care,' which involved a similar number of visits, a specific 211u001eexplanation of the spinal problem, and a series of instructional pamphlets. 211u001ePatients were followed using telephone interview at 2, 4, and 8 weeks. Our major 211u001eoutcomes were time to functional recovery, Roland-Morris disability scale, and 211u001esatisfaction.