As reported in Annals of Internal Medicine, Bronfort and colleagues enrolled 192 adults with back pain that had been radiating into the leg for at least four weeks. Patients were recruited through newspaper advertisements, direct mail, and community posters.
Half the patients received instructions for specific exercises to do at home plus simple pain management techniques. In addition, during the first 12 weeks, they visited a chiropractor up to 20 times for 10 to 20 minutes of spinal manipulation at each visit.
Patients in the other group also received the instructions for exercises and pain management techniques. They too met with a chiropractor, exercise therapist, or personal trainer during the first 12 weeks, but for four one-hour sessions without spinal manipulation.
The patients were asked to rate their pain at the beginning of the study, after the 12 weeks of treatments and again at the end of the year.
At 12 weeks, 37 percent of the spinal manipulation group felt their pain was reduced by at least three-quarters, compared to 19 percent of those who received exercise and advice only.
In addition, the patients who had spinal manipulation had higher scores for overall improvement and satisfaction.
By the one-year follow-up, the no-manipulation group had caught up, and there was no longer a significant difference in pain relief. But the scores for overall improvement and satisfaction remained higher for the patients who received spinal manipulative therapy.