OBJECTIVE: To compare prospectively the effect of manual treatment such as manipulation, specific mobilization, muscle stretching, auto-traction, and cortisone injections with standardized conventional but optimized activating treatmentby primary health care teams. DESIGN: Prospective controlled multicentre trial with four months' follow-up. SETTING: Kopparberg County, Sweden. Six primary health care or occupational health care centres, representing a catchment area of 56000 residents participated. PARTICIPANTS: 101 outpatients with acute or subacute low-back pain were, during the period February 1988 to April 1989, randomly allocated to one of two treatment groups. MAIN OUTCOME MEASURE: Quality of life was assessed at baseline and at four months by means of visual analogue scales (VAS). The occurrence of 27 different symptoms of a psychosomatic character was surveyed initially and at four months by questions answered by "yes" or "no" in a questionnaire. RESULTS: There were significant differences concerning quality of life and presence of general symptoms in favour of the group receiving manual treatment with steroid injections. CONCLUSION: Manual treatment with steroid injections was superior to conventional treatment in minimizing mental and somatic symptoms and increasing quality of life, in parallel with other measures of improvement.
RCT Entities:
OBJECTIVE: To compare prospectively the effect of manual treatment such as manipulation, specific mobilization, muscle stretching, auto-traction, and cortisone injections with standardized conventional but optimized activating treatment by primary health care teams. DESIGN: Prospective controlled multicentre trial with four months' follow-up. SETTING: Kopparberg County, Sweden. Six primary health care or occupational health care centres, representing a catchment area of 56000 residents participated. PARTICIPANTS: 101 outpatients with acute or subacute low-back pain were, during the period February 1988 to April 1989, randomly allocated to one of two treatment groups. MAIN OUTCOME MEASURE: Quality of life was assessed at baseline and at four months by means of visual analogue scales (VAS). The occurrence of 27 different symptoms of a psychosomatic character was surveyed initially and at four months by questions answered by "yes" or "no" in a questionnaire. RESULTS: There were significant differences concerning quality of life and presence of general symptoms in favour of the group receiving manual treatment with steroid injections. CONCLUSION: Manual treatment with steroid injections was superior to conventional treatment in minimizing mental and somatic symptoms and increasing quality of life, in parallel with other measures of improvement.
Authors: Neil M Paige; Isomi M Miake-Lye; Marika Suttorp Booth; Jessica M Beroes; Aram S Mardian; Paul Dougherty; Richard Branson; Baron Tang; Sally C Morton; Paul G Shekelle Journal: JAMA Date: 2017-04-11 Impact factor: 56.272