A recent study has shown sustained chiropractic care and home exercise produced better outcomes for back related leg pain than home exercise alone. The study published in the highly respected Annals of Internal Medicine showed that patients who had combined chiropractic care – referred to as spinal manipulation therapy (SMT) in the study, with home exercise and advice (HEA) had better results than those who had at home exercise only (1).
In the study patients in each group rated their back related leg pain (BRLP) at 12 and 52 weeks. The chiropractic care plus home exercise advice group had a clinically important advantage over home exercise and advice alone at 12 weeks. Chiropractic care ceased after 12 weeks, and while this benefit did not remain at 52 weeks, the chiropractic care plus home exercise and advice group sustained better secondary outcomes in terms of patient global improvement, satisfaction and reduced need for medication use.
Chiropractors’ Association of Australia spokesperson Dr Billy Chow (Chiropractor) says chiropractic research is increasingly targeting conditions such as low back pain in order to reduce the impact these complaints have on the Australian community.
“While this is only a single study it may be an indication that an ongoing minimum dose level of chiropractic care is required to sustain long term outcomes for the reduction in complaints such as back related leg pain. Such a study might be the next logical step and help us quantify the importance of chiropractic maintenance care.”
Future research may now need to look at longer-term outcomes when chiropractic care is continued at a minimal level and after the initial intensive period of care.
An estimated 3 million Australians (13.6% of the total population) have back problems including 2.8 million with back and disc disorders and an additional 0.2 million with sciatica according to the Australian Institute of Health and Welfare (AIHW) figures (2).
The Global Burden of Disease (GBD) measures disability in order to gain a better understanding of disease impact on society. Low-back pain is rated the number one burden in terms of years lived with disability in developed countries (3).
Australians are increasingly turning toward chiropractic care to manage a range of musculoskeletal complaints with over 215,000 visits to a chiropractors occurring in Australia each week (4).
To read an abstract of the study visit http://annals.org/article.aspx?articleid=1905126
References
- Gert Bronfort, et al., Spinal Manipulation and Home Exercise With Advice for Subacute and Chronic Back-Related Leg Pain: A Trial With Adaptive Allocation. Ann Intern Med. , 2014. 161(6): p. 381-391.
- AIHW, Arthritis and other musculoskeletal conditions across the life stages., in Arthritis series no. 18. Cat. no. PHE 173. AIHW 2014: Canberra.
- Murray CJL, V.T., Lozano R, Naghavi M, Flaxman AD, Michaud C, et al., Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study Lancet, 2010. 380: p. 2197-223.
- Australian Bureau of Statistics (2004-2005). National Health Survey: Summary of Results, N. 4364.0. Canberra, Australian Capital Territory.
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