NSAIDs and Manipulation Ineffective for Acute Low Back Pain

Best Evidence Review

Assessment of Diclofenac or Spinal Manipulative Therapy, or Both, in Addition to Recommended First-line Treatment for Acute Low Back Pain: A Randomized Controlled Trial

Hancock MJ, Maher GC, Latimer J, et al
Lancet. 2007;370:1638-1643

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Abstract

Previous recommendations have noted that nonsteroidal anti-inflammatory drugs (NSAIDs) and spinal manipulation therapy can be helpful for patients with acute low back pain, but the current study compares this approach with a “usual care” group, who received advice on physical activity and regular doses of paracetamol. The researchers’ findings are surprising and should change the way clinicians think about the management of low back pain.

This study was selected from Medscape Best Evidence, which uses the McMaster Online Rating of Evidence System. Of a possible top score of 7, this study was ranked as 6 for relevance and 5 newsworthiness by clinicians who used this system.

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