Abstract | BACKGROUND: Back and neck pain are very common, disabling and recurrent disorders in the general population and the knowledge of long-term effect of treatments are sparse. The aim of this study was to compare the long-term effects (up to one year) of naprapathic manual therapy and evidence-based advice on staying active regarding non-specific back and/or neck pain. Naprapathy, a health profession mainly practiced in Sweden, Finland, Norway and in the USA, is characterized by a combination of manual musculoskeletal manipulations, aiming to decrease pain and disability in the neuromusculoskeletal system. METHODS: Subjects with non-specific pain/disability in the back and/or neck lasting for at least two weeks (n = 409), recruited at public companies in Sweden, were included in this pragmatic randomized controlled trial. The two interventions compared were naprapathic manual therapy such as spinal manipulation/mobilization, massage and stretching, (Index Group), and advice to stay active and on how to cope with pain, provided by a physician (Control Group). Pain intensity, disability and health status were measured by questionnaires. RESULTS: 89% completed the 26-week follow-up and 85% the 52-week follow-up. A higher proportion in the Index Group had a clinically important decrease in pain (risk difference (RD) = 21%, 95% CI: 10-30) and disability (RD = 11%, 95% CI: 4-22) at 26-week, as well as at 52-week follow-ups ( pain: RD = 17%, 95% CI: 7-27 and disability: RD = 17%, 95% CI: 5-28). The differences between the groups in pain and disability considered over one year were statistically significant favoring naprapathy (p < or = 0.005). There were also significant differences in improvement in bodily pain and social function (subscales of SF-36 health status) favoring the Index Group. CONCLUSIONS: Combined manual therapy, like naprapathy, is effective in the short and in the long term, and might be considered for patients with non-specific back and/or neck pain. TRIAL REGISTRATION: Current Controlled Trials ISRCTN56954776.
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Authors | Eva Skillgate, Tony Bohman, Lena W Holm, Eva Vingård, Lars Alfredsson |
Journal | BMC musculoskeletal disorders
(BMC Musculoskelet Disord)
Vol. 11
Pg. 26
(Feb 05 2010)
ISSN: 1471-2474 [Electronic] England |
PMID | 20137063
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Back Pain
(therapy)
- Complementary Therapies
(methods)
- Disability Evaluation
- Evidence-Based Practice
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Musculoskeletal Manipulations
- Neck Pain
(therapy)
- Quality of Life
- Social Behavior
- Treatment Outcome
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