A review of the evidence for the effectiveness, safety, and cost of acupuncture, massage therapy, and spinal manipulation for back pain

Article Abstract:

Background: Few treatments for back pain are supported by strong scientific evidence. Conventional treatments, although widely used, have had limited success. Dissatisfied patients have, therefore, turned to complementary and alternative medical therapies and providers for care for back pain. Purpose: To provide a rigorous and balanced summary of the best available evidence about the effectiveness, safety, and costs of the most popular complementary and alternative medical therapies used to treat back pain. Data Sources: MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. Study Selection: Systematic review of randomized, controlled trials (RCTs) that were published since 1995 and that evaluated acupuncture, massage therapy, or spinal manipulation for nonspecific back pain and RCTs published since the reviews were conducted. Data Extraction: Two authors independently extracted data from the reviews (including number of RCTs, type of back pain, quality assessment, and conclusions) and original articles (including type of pain, comparison treatments, sample size, outcomes, follow-up intervals, loss to follow-up, and authors' conclusions.) Data Synthesis: Because the quality of the 20 RCTs that evaluated acupuncture was generally poor, the effectiveness of acupuncture for treating acute or chronic back pain is unclear. The three RCTs that evaluated massage reported that this therapy is effective for subacute and chronic back pain. A meta-regression analysis of the results of 26 RCTs evaluating spinal manipulation for acute and chronic back pain reported that spinal manipulation was superior to sham therapies and therapies judged to have no evidence of a benefit but was not superior to effective conventional treatments. Conclusions: Initial studies have found massage to be effective for persistent back pain. Spinal manipulation has small clinical benefits that are equivalent to those of other commonly used therapies. The effectiveness of acupuncture remains unclear. All of these treatments seem to be relatively safe. Preliminary evidence suggests that massage, but not acupuncture or spinal manipulation, may reduce the costs of care after an initial course of therapy.

Massage, Acupuncture, Author Abstract

---

Congruence between decisions to initiate chiropractic spinal manipulation for low back pain and appropriateness criteria in North America

Article Abstract:

Many spinal manipulations performed by chiropractors appear to be initiated for appropriate medical symptoms. Researchers evaluated the medical records of 859 patients seen by chiropractors. A panel of chiropractors and medical specialists determined that 46% of patients received spinal manipulation appropriately, and 25% of patients received care of uncertain appropriateness. The panel concluded that, in 29% of cases, spinal manipulation was initiated inappropriately. The proportion determined to be appropriate is similar to evaluations of other medical procedures.

Health aspects

---

The effectiveness of spinal manipulation relative to other therapies for low back pain

Article Abstract:

Spinal manipulation is as effective as many other traditional treatments for low back pain, including pain killers, physical therapy, and exercise. This was the conclusion of researchers who analyzed 39 clinical trials comparing spinal manipulation with many other treatments. Spinal manipulation is usually performed by a chiropractor, physical therapist, or osteopathic doctor.

Similar abstracts:

• Abstracts: More than the poor: courts and Congress expand scope of patient transfer law. AIDS patient claims hospital violated ADA, 'dumping' law
• Abstracts: Regulatory T-cell development: Is Foxp3 the decider? Effective cancer therapy through immunmodulation. Immunotherapy: past, present and future
• Abstracts: Preventing abuse of the NHS. Rehabilitation and continence promotion following a stroke. Auditing continence services
• Abstracts: A profile of current Internet users in dentistry. Dental informatics: a cornerstone of dental practice. The technologically well-equipped dental office
• Abstracts: Low-fat dietary pattern and risk of invasive breast cancer: The women's health initiative randomized dietary modification trial

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.