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Study in Spine shows combined chiropractic and medical care more effective than medical care alone for acute low back pain
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Patients with acute low back pain receiving a combination of chiropractic manipulative therapy and standard medical care experienced a statistically and clinically significant reduction in their back pain and improved physical functioning when compared to those receiving standard medical care alone, reports an article in the April 15 issue of Spine (online version).

The pragmatic, patient-centered, two-arm randomized controlled trial pilot study was funded by a grant from the Samueli Institute, and conducted from February 2008 to June 2009 at William Beaumont Army Medical Center. Participants were 91 active-duty military personnel between the ages of 18 and 35 years old.

"While a number of studies have shown spinal manipulation to be effective in treating low back pain in research settings, the appropriate role of chiropractic care in treating low back pain within the health care delivery system, including the military, has not been clearly established," says study Principal Investigator Christine Goertz, D.C., Ph.D., vice chancellor for research and health policy for Palmer College of Chiropractic. "This study was the first step in filling that gap in our knowledge."

Study highlights included:
  • Adjusted mean Roland-Morris Disability Questionnaire scores were significantly better in the standard medical care plus chiropractic manipulative therapy group than in the standard medical care group at both week two (8.9 vs. 12.9; p = <0.001) and week four (8.0 vs. 12.0; p = 0.004).
  • Mean Numerical Pain Rating Scale (0-10) scores were significantly improved in the group that received chiropractic manipulative therapy when compared to standard medical care alone at both week two (3.9 vs. 6.1; p = <0.001) and week four (3.9 vs. 5.2; p = < 0.02).
  • Seventy-three percent of participants in the standard medical care plus chiropractic manipulative therapy group rated their global improvement as pain completely gone, much better or moderately better, compared to 17% in the standard medical care group.

"While these findings are exciting, they need to be confirmed with additional research that replicates this study on a larger scale," Dr. Goertz adds.

Palmer College, the RAND Corporation and Samueli Institute are doing just that. Collaboratively, they received a $7.4 million, four-year grant from the Department of Defense in 2011 to conduct a similar multi-site clinical trial, this time with a sample size of 750 active-duty military personnel.

The first clinical trial, as part of this study, will examine chiropractic’s effectiveness in relieving low back pain and improving functions in active-duty service members. Assessment of Chiropractic Treatment 1 (ACT1), is recruiting participants and collecting data at three military bases: Pensacola, Fla., Bethesda, Md., and San Diego, Calif.

Assessment of Chiropractic Treatment 2 (ACT2) will compare differences in reflexes and reaction time before and after chiropractic treatment in members of Special Operations Forces. The study will begin participant recruitment and data collection in summer 2013. Currently, study methods are being piloted with Doctor of Chiropractic student volunteers on the Davenport Campus.

Assessment of Chiropractic Treatment 3 (ACT3) will assess military readiness by evaluating differences in strength, balance and recurrences following chiropractic treatment in service members that are deployment ready. Military site participant recruitment and data collection is expected to begin in fall 2013.

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