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Manipulation vs. Pain Medication

An April 2013 study in compared manipulation with a placebo medication to fake manipulation with the drug Diclofenate.

Key findings include:

A definite difference existed between the groups the manipulation group showed a quick and more more robust decrease in Roland scores

The pain numbers also improved faster and farther in the manipulation group versus the pain medication group. Subjects took 3 times the amount of medication in the non-manipulation group, although these results were not significant do to sample size

The design for his study was double blinded, randomized and controlled for placebo which had three treatment arm originally .

The purpose of this investigation was to determine if manipulation was more effective in treating acute lower back pain than the NSAIDS Diclofenac.

Lower back pain is a large problem in our society, this trial set out to compare manipulation to the noted NASAID and placebo in regards to how happy patients are with the treatment, lost work time and pain medication use.

Over 100 patients took part in this trial. These subjects were recruited from 5 practices, and then randomized into 1 of the 3 arms of the trial. The 3rd arm was sham manipulation and placebo medication. The data was rated by a person who was unaware of which arm the patient was following. The values rated included a self score of disability, use of pain meds, lost work time, and sf-12 form.

In the results, 37 received the HVLA (high velocity low amplitude thrusts), and 38 received the drug. The third arm was closed due to a high dropout rate. Results in the HVLA group were better than the medication group at a statistically significant level.

The number of patients that joined the trial was 20% of those approached due to the large number of exclusion criterion , and he number of patients unwilling to sign the consent form. All patients were given a rescue medication (Paracetomal) to be used as required, but not to exceed 6 tablets over a 24 hour period.