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Chronic lower back pain and Maintenance care

“Nonspecific LBP represents about 85% of LBP patients seen in primary care. About 10% will go on to develop chronic, disabling LBP.  It is this group of LBP that uses the majority of healthcare and socioeconomic costs.” 

Most of the studies concerned about the therapeutic effects of SM investigated these effects only for a short term.  Studies that extend beyond short effects showed further improvements.

It is hypothesized that if spinal manipulation therapy (SMT) can be maintained for longer periods, it will be more beneficial in maintaining the desirable outcomes obtained after short-term treatment.

The goal of this study was to assess the effectiveness of SMT for the management of chronic nonspecific LBP and to determine the effectiveness of maintenance SMT in long-term reduction of pain and disability levels associated with chronic low back conditions after an initial phase of treatments. 

This study looked at 3 groups;

Sham SMT (12 visits over 4 weeks)

No Maintained SMT (12 visits over 4 weeks)

Maintained SMT (12 visits over 4 weeks plus 1x every 2 weeks for the next 9 months).

A posterior pelvic tilt exercise was given to all three.

Results

After 4 weeks the No Maintained and Maintained SMT groups had significant improvements in pain ratings and disability compared to Sham SMT.  After 1 month the Sham SMT and No Maintained SMT group’s disability and pain levels returned back towards initial baseline. The Maintained SMT group slowly continued to improve.  

SMT is effective for the treatment of chronic nonspecific LBP. To obtain long-term benefit, this study suggests maintenance SM after the initial intensive manipulative.

Reference

https://doi.org/10.1097/brs.0b013e3181f5dfe0

Here’s another post I did awhile back. Chiropractic and Maintenance Care