A Double-Blinded Randomized Controlled Trial in Comparison With Diclofenac and Placebo

von Heymann, Wolfgang J. Dr. Med
Spine: 01 April 2013 – Volume 38 – Issue 7 – p 540–548

Abstract
Study Design. A randomized, double-blinded, placebo-controlled, parallel trial with 3 arms.

Objective. To investigate in acute nonspecific low back pain (LBP) the effectiveness of spinal high-velocity low-amplitude (HVLA) manipulation compared with the nonsteroidal anti-inflammatory drug diclofenac and with placebo.

Summary of Background Data. LBP is an important economical factor in all industrialized countries. Few studies have evaluated the effectiveness of spinal manipulation in comparison to nonsteroidal anti-inflammatory drugs or placebo regarding satisfaction and function of the patient, off-work time, and rescue medication.

Methods. A total of 101 patients with acute LBP (for

Results. Thirty-seven subjects received spinal manipulation, 38 diclofenac, and 25 no active treatment. The placebo group with a high number of dropouts for unsustainable pain was closed praecox. Comparing the 2 active arms with the placebo group the intervention groups were significantly superior to the control group. Ninety subjects were analyzed in the collective intention to treat. Comparing the 2 intervention groups, the manipulation group was significantly better than the diclofenac group (Mann-Whitney test: P = 0.0134). No adverse effects or harm was registered.

Conclusion. In a subgroup of patients with acute nonspecific LBP, spinal manipulation was significantly better than nonsteroidal anti-inflammatory drug diclofenac and clinically superior to placebo.

Journal Website Abstract:  http://journals.lww.com/spinejournal/Abstract/2013/04010/Spinal_High_Velocity_Low_Amplitude_Manipulation_in.3.aspx