Chiropractic and Medical Care combination treatment

Adding Chiropractic Manipulative Therapy to Standard Medical Care for
Patients With Acute Low Back Pain: Results of a Pragmatic Randomized
Comparative Effectiveness Study
Goertz, Christine M. DC, PhD
http://journals.lww.com/spinejournal/Abstract/2013/04150/Adding_Chiropractic_Manipulative_Therapy_to.2.aspx

Spine: 15 April 2013 - Volume 38 - Issue 8 - p 627--634

Abstract
Study Design. Randomized controlled trial.

Objective. To assess changes in pain levels and physical functioning in
response to standard medical care (SMC) versus SMC plus chiropractic
manipulative therapy (CMT) for the treatment of low back pain (LBP)
among 18 to 35-year-old active-duty military personnel.

Summary of Background Data. LBP is common, costly, and a significant
cause of long-term sick leave and work loss. Many different
interventions are available, but there exists no consensus on the best
approach. One intervention often used is manipulative therapy. Current
evidence from randomized controlled trials demonstrates that
manipulative therapy may be as effective as other conservative
treatments of LBP, but its appropriate role in the healthcare delivery
system has not been established.

Methods. Prospective, 2-arm randomized controlled trial pilot study
comparing SMC plus CMT with only SMC. The primary outcome measures were
changes in back-related pain on the numerical rating scale and physical
functioning at 4 weeks on the Roland-Morris Disability Questionnaire and
back pain functional scale (BPFS).

Results. Mean Roland-Morris Disability Questionnaire scores decreased in
both groups during the course of the study, but adjusted mean scores
were significantly better in the SMC plus CMT group than in the SMC
group at both week 2 (P < 0.001) and week 4 (P = 0.004). Mean numerical
rating scale pain scores were also significantly better in the group
that received CMT. Adjusted mean back pain functional scale scores were
significantly higher (improved) in the SMC plus CMT group than in the
SMC group at both week 2 (P < 0.001) and week 4 (P = 0.004).

Conclusion. The results of this trial suggest that CMT in conjunction
with SMC offers a significant advantage for decreasing pain and
improving physical functioning when compared with only standard care,
for men and women between 18 and 35 years of age with acute LBP.