edzardernst.com
Chiropractic manipulation is not the best therapy for back pain of seniors
The debate what might be the optimal treatment of back pain has been going on for many years. This new study provides important further insights. The RCT assessed the comparative effectiveness of adding spinal manipulative therapy (SMT) or supervised rehabilitative exercise to home exercise in adults 65 or older suffering from sub-acute or chronic low back pain (LBP). Treatments were provided over 12-weeks and self-report outcomes were collected at 4, 12, 26, and 52 weeks. The primary outcome was pain severity. Secondary outcomes included back disability, health status, medication use, satisfaction with care, and global improvement. Linear mixed models were used to analyse outcomes. The primary analysis included longitudinal outcomes in the short (week 4–12) and long-term (week 4–52). An omnibus test assessing differences across all groups over the year was used to control for multiplicity. Secondary analyses included outcomes at each time point and responder analyses. This study was