Study in Spine shows combined chiropractic
and medical care more effective than
medical care alone for acute low back pain
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.