What’s the best treatment for chronic low-back pain?
Not surprisingly, I’d say chiropractic, but I would wouldn’t I. But so do: Haas M, Goldberg B, Aickin M, Ganger B and Attwood M. in their study called:
A practice-based study of patients with acute and chronic low back pain attending primary care and chiropractic physicians: two-week to 48-month follow-up.
Now, this study looked at patients with acute (or severe) and chronic low-back pain. It compared standard medical treatment to chiropractic care for this common problem. A pretty robust number of patients were examined (2780 patients over a 2-year period). There were 60 chiropractic doctors (treating 1855 of the patients) and 111 medical doctors (treating 925 patients) in the study group.
The medical doctors treated their patients with a regimen of prescription drugs, an exercise plan and self-care advice. Some of these patients also received physical therapy. The chiropractic doctors treated their patients with a regimen of spinal manipulation, physical therapy, an exercise plan and self-care education. The success of any treatment was measured by the patient’s report of their degree of pain and/or disability. Patients were given a pain questionnaire on their first visit. This was then followed up with regular questionnaires over a period of 4 years.
What were the key findings?
- Those patients who were treated by the medical doctors initially had a greater degree of low-back pain and disability as well as pain radiating below the knee. They also had poorer general health than those patients who are treated by a chiropractor.
- Those patients who were treated by the chiropractors saw a modest advantage in their low-back pain relief over those treated by the medical doctors in the first 12 months. The greatest difference was in those patients who had chronic lower back pain. There was a noticeable statistical advantage in the chiropractic patients with chronic pain below the knee.
The important point in this study is to note that ALL patient groups saw significant improvement in pain and disability over the course of treatment.
Those patients who were experiencing acute pain saw the greatest improvement. Many of them gaining almost complete relief of their pain. However, 3 years into this study, up to 75% of the patients had experienced at least 30 days of pain in the previous year. This was even those who had seen significant pain and disability relief through early intervention.
So what does this study ultimately prove?
Here are two key take-aways:
- The earlier you can deal with chronic low-back pain, the more effective the treatment is. In the study, those patients who dealt with their pain early on experienced fewer days of back pain compared to those who had waited before seeking treatment. Overall, their treatments were more successful in reducing their pain. So, if you are experiencing back pain – don’t delay. Early intervention can play a huge part in your recovery for the long run.
- Chiropractic care can be more beneficial than medical care for certain kinds of pain. For those patients who had chronic low-back pain and those with pain below the knee chiropractic care was the most effective. Equally importantly, those patients who visited their chiropractor felt relief within the first 3 months.
Haas M, Goldberg B, Aickin M, Ganger B, Attwood M. A practice-based study of patients with acute and chronic low back pain attending primary care and chiropractic physicians: two-week to 48-month follow-up. Journal of Manipulative and Physiological Therapeutics 2004;27(3):160-169.