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Bibliometric Analysis of Research Trends on Manual Therapy for Low Back Pain Over Past 2 Decades

Published September 6, 2023

New Study Shows Treatment of Chronic Low Back Pain
by a Physical Therapist Using Manipulation and Exercise Is Beneficial

Estimates are that low back pain affects 80% of the population at some point in their life. According to the authors of a study published in a 2003 summer edition of the medical journal Spine states, “Chronic low back pain is the most common complaint of the working-age population.” In the study, people with chronic low back pain treated by physical therapists using manual therapy spinal manipulation techniques and exercise were compared with people seen by a physician who gave them educational material alone. The research, done in Finland at the Rehabilitation Unit of the Orthopaedic Hospital Orton and the Universities of Helsinki and Tampere, takes into account that in Europe, manual therapy is recognized as a specialty area of physical therapy.

The authors of the study note that in addition to human suffering, chronic low back pain can cause a substantial economic burden to sufferers attributable to absence from work and the wide use of medical services. Often acute low back pain resolves with conservative treatment or without any treatment, but the back pain appears to recur and become chronic more often than expected.

"As physical therapists, we’ve studied treatment of recent onset or acute low back pain using spinal manipulation," says physical therapist Kenneth A. Olson, president of the American Academy of Orthopaedic Manual Physical Therapists. "Now this study confirms our clinical experience that people with chronic, longstanding low back pain benefit substantially from treatment using manual therapy techniques of spinal manipulation along with exercise."

All participants in the study were clinically examined by a physician, provided with an educational booklet and given specific instructions on how to cope with low back pain. Most participants followed up with the MD at the end of the study. For the consultation group this was their only treatment.

Participants in the group that received physical therapy were treated for an average of four visits over four weeks. They received specific spinal manipulation using muscle energy technique and stabilizing exercises aimed at correcting the lumbopelvic rhythm.

At the five-month and one-year follow-ups, the physical therapy treatment group showed more significant reductions in pain intensity and in self-rated disability than the consultation group. Both groups showed similar improvement in health-related quality of life, decreased use of analgesic medications and less health care-related costs. Since the average duration of back pain for people in the study was six to eight years, the improvement was unlikely due to time alone, the study concludes.
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