A comparison between chiropractic management and pain clinic management for chronic low-back pain in a National Health Service Outpatient Clinic

Adam Wilkey, Michael Gregory, David Byfield, Peter McCarthy

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: To compare outcomes in perception of pain and disability for a group of patients suffering with chronic low-back pain (CLBP) when managed in a hospital by either a regional pain clinic or a chiropractor.

DESIGN: The study was a pragmatic, randomized, controlled trial.

SETTING: The trial was performed at a National Health Service (NHS) hospital outpatient clinic (pain clinic) in the United Kingdom.

SUBJECTS AND INTERVENTIONS: Patients with CLBP (i.e., symptom duration of andgt;12 weeks) referred to a regional pain clinic (outpatient hospital clinic) were assessed and randomized to either chiropractic or pain-clinic management for a period of 8 weeks. The study was pragmatic, allowing for normal treatment protocols to be used. Treatment was administered in an NHS hospital setting.

OUTCOME MEASURES: The Roland-Morris Disability Questionnaire (RMDQ) and Numerical Rating Scale were used to assess changes in perceived disability and pain. Mean values at weeks 0, 2, 4, 6, and 8 were calculated. The mean differences between week 0 and week 8 were compared across the two treatment groups using Student's t-tests. Ninety-five percent (95%) confidence intervals (CIs) for the differences between groups were calculated.

RESULTS: Randomization placed 12 patients in the pain clinic and 18 in the chiropractic group, of which 11 and 16, respectively, completed the trial. At 8 weeks, the mean improvement in RMDQ was 5.5 points greater for the chiropractic group (decrease in disability by 5.9) than for the pain-clinic group (0.36) (95% CI 2.0 points to 9.0 points; p = 0.004). Reduction in mean pain intensity at week 8 was 1.8 points greater for the chiropractic group than for the pain-clinic group (p = 0.023).

CONCLUSIONS: This study suggests that chiropractic management administered in an NHS setting may be effective for reducing levels of disability and perceived pain during the period of treatment for a subpopulation of patients with CLBP.
Original languageEnglish
Pages (from-to)465 - 473
Number of pages8
JournalThe Journal of Alternative and Complementary Medicine
Volume14
Issue number5
DOIs
Publication statusPublished - 1 Jan 2008

Keywords

  • chronic low-back pain (clbp)
  • pain clinic
  • chiropractor

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