A Cochrane Review of Combined Chiropractic Interventions for Low-Back Pain

  title={A Cochrane Review of Combined Chiropractic Interventions for Low-Back Pain},
  author={Bruce Walker and Simon D. French and William D. Grant and Sally E. Green},
Study Design. Cochrane systematic review of randomized controlled trials. Objective. To determine the effects of combined chiropractic interventions on pain, disability, back-related function, overall improvement, and patient satisfaction in adults with low-back pain (LBP). Summary of Background Data. Chiropractors commonly use a combination of interventions to treat people with LBP, but little is known about the effects of this care. Methods. We used a comprehensive search strategy. All… 

Effectiveness and Economic Evaluation of Chiropractic Care for the Treatment of Low Back Pain: A Systematic Review of Pragmatic Studies

Moderate evidence suggests that chiropractic care for LBP appears to be equally effective as physical therapy and limited evidence suggests the same conclusion when chiropractor care is compared to exercise therapy and medical care although no firm conclusion can be reached.

Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis

Clinically relevant effects of OMT were found for reducing pain and improving functional status in patients with acute and chronic nonspecific LBP and for LBP in pregnant and postpartum women at 3 months posttreatment.

Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain

It is suggested that spinal manipulative therapy may be as effective as other recommended therapies for the management of non-specific and chronic primary spine pain, including standard medical care or physical therapy.

Effectiveness of chiropractic modality on chronic low back pain patients, A quasi-experimental study

Complementary chiropractic treatment amongst chronic LBP patients may be an appropriate adjuvant to conventional treatments to improve disability and pain intensity reduction in both genders.

Comparative Effectiveness of Chuna Manipulative Therapy for Non-Acute Lower Back Pain: A Multi-Center, Pragmatic, Randomized Controlled Trial

CMT plus UC showed higher effectiveness compared to UC alone in patients with non-acute LBP in reducing LBP and leg pain and in improving function with good safety results using a powered sample size and including mid-term follow-up.

Addition of MoodGYM to physical treatments for chronic low back pain: A randomized controlled trial

There was no additional benefit of an internet-delivered CBT program (MoodGYM) to physical treatments in those with chronic non-specific LBP at medium risk of ongoing disability measured at post-treatment, or at 6 and 12 months.

Non-radicular low back pain: Assessment and evidence-based treatment.

Clinicians will be able to help clinicians assess patients with LBP and formulate evidence-based treatment decisions according to the presence of red flags and pain type.

The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews

A systematic review of MT with a literature search covering the period of January 2000 to April 2013 updates the evidence for MT with exercise or UMC for different stages of LBP and provides recommendations for future studies.



A randomized clinical trial and subgroup analysis to compare flexion–distraction with active exercise for chronic low back pain

Overall, flexion–distraction provided more pain relief than active exercise; however, these results varied based on stratification of patients with and without radiculopathy and with and with recurrent symptoms.

Effectiveness of Four Conservative Treatments for Subacute Low Back Pain: A Randomized Clinical Trial

For subacute low back pain, combined joint manipulation and myofAscial therapy was as effective as joint manipulation or myofascial therapy alone, and back school was aseffective as three manual treatments.

Low back pain of mechanical origin: randomised comparison of chiropractic and hospital outpatient treatment.

For patients with low back pain in whom manipulation is not contraindicated chiropractic almost certainly confers worthwhile, long term benefit in comparison with hospital outpatient management, the benefit is seen mainly in those with chronic or severe pain.

A comparison of physical therapy, chiropractic manipulation, and provision of an educational booklet for the treatment of patients with low back pain.

For patients with low back pain, the McKenzie method of physical therapy and chiropractic manipulation had similar effects and costs, and patients receiving these treatments had only marginally better outcomes than those receiving the minimal intervention of an educational booklet.

A comparison between chiropractic management and pain clinic management for chronic low-back pain in a national health service outpatient clinic.

It is suggested 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 chronic low-back pain.

Chiropractic and exercise for seniors with low back pain or neck pain: the design of two randomized clinical trials

These are the first randomized clinical trials to comprehensively address clinical effectiveness, cost-effectiveness, and patients' perceptions of commonly used treatments for elderly LBP and NP sufferers.

Trunk exercise combined with spinal manipulative or NSAID therapy for chronic low back pain: a randomized, observer-blinded clinical trial.

Each of the three therapeutic regimens was associated with similar and clinically important improvement over time that was considered superior to the expected natural history of long-standing CLBP.

Functional outcomes of low back pain: comparison of four treatment groups in a randomized controlled trial.

It is concluded that both instruments are reliable for measuring low back pain disability, and chiropractic manipulation has a superior short-term benefit when compared to stroking massage and TMS in subacute low backPain patients.

A Randomized Trial of Medical Care With and Without Physical Therapy and Chiropractic Care With and Without Physical Modalities for Patients With Low Back Pain: 6-Month Follow-Up Outcomes From the UCLA Low Back Pain Study

After 6 months of follow-up, chiropractic care and medical care for low back pain were comparable in their effectiveness and physical therapy may be marginally more effective than medical care alone for reducing disability in some patients, but the possible benefit is small.

Nonsteroidal Anti-Inflammatory Drugs for Low Back Pain: A Systematic Review Within the Framework of the Cochrane Collaboration Back Review Group

The evidence from the 51 trials included in this review suggests that nonsteroidal anti-inflammatory drugs are effective for short-term symptomatic relief in patients with acute low back pain and there does not seem to be a specific type of nonsteroid anti- inflammatory drug that is clearly more effective than others.