Evidence-informed management of chronic low back pain with spinal manipulation and mobilization

Brønfort, Gert; Haas, M.; Evans, Roni; Kawchuk, Greg; Dagenais, Simon

doi:10.1016/j.spinee.2007.10.023

Cited by 152 publications

(97 citation statements)

References 73 publications

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“…Four systematic reviews (Bronfort, Haas, Evans, Kawchuk, & Dagenais, 2008;Bronfort, Haas, Evans, & Bouter, 2004;Vernon & Humphreys, 2008;Vernon, Humphreys, & Hagino, 2007) and one Cochrane review (Gross et al, 2010) have recently been conducted on the effectiveness of spinal manipulation in the treatment of lower back and neck pain. In these reviews, the authors focussed on patient reported outcome measures such as the visual analogue scale, the 11 point numerical pain reporting scale, and the neck disability index.…”

Section: Spinal Manipulation In Clinical Painmentioning

confidence: 99%

“…In regard to patient reported pain levels, Bronfort et al (2004) and Bronfort et al (2008) found a moderate level of evidence to suggest that spinal manipulation is comparable in effect to a 41 prescribed Non-Steroidal Anti-Inflammatory Drug (NSAID) for the short (<3months) and long term (>3 months) relief of chronic lower back pain. These authors also found a moderate level of evidence that spinal manipulation is more effective than general practitioner care and other methods of physical therapy in the treatment for chronic lower back pain (Bronfort et al, 2004).…”

Section: Spinal Manipulation In Clinical Painmentioning

confidence: 99%

“…In regard to interventions that utilised more than one treatment, there was "limited to moderate" evidence to suggest that manipulation is superior to other manual therapy and home exercise in both the short and long term treatment of chronic lower back pain (Bronfort et al, 2008;Bronfort et al, 2004). In regard to placebo, Bronfort et al (2008) reported a moderate level of evidence that manipulation is superior in effect for the treatment of chronic lower back pain, however, (Bronfort et al, 2004) found only limited evidence of its efficacy.…”

Section: Spinal Manipulation In Clinical Painmentioning

confidence: 99%

See 2 more Smart Citations

The Effect of Cervical Spine Manipulation on Postural Sway in Patients With Nonspecific Neck Pain

Fisher

Bacon

Mannion

2015

Journal of Manipulative and Physiological Therapeutics

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Section: Spinal Manipulation In Clinical Painmentioning

confidence: 99%

Section: Spinal Manipulation In Clinical Painmentioning

confidence: 99%

Section: Spinal Manipulation In Clinical Painmentioning

confidence: 99%

See 1 more Smart Citation

The Effect of Cervical Spine Manipulation on Postural Sway in Patients With Nonspecific Neck Pain

Fisher

Bacon

Mannion

2015

Journal of Manipulative and Physiological Therapeutics

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“…Current evidence suggests that spinal manipulation, a central component of chiropractic treatment, may provide benefit in some cases of low back and neck pain [5][6].…”

mentioning

confidence: 99%

Management of Operation Iraqi Freedom and Operation Enduring Freedom veterans in a Veterans Health Administration chiropractic clinic: A case series

Lisi

2010

JRRD

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Abstract-Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans commonly seek care for musculoskeletal complaints in Veterans Health Administration (VHA) facilities. Chiropractic services for musculoskeletal conditions have recently been introduced to VHA. No reports have been published on chiropractic care for OIF/OEF veterans. This study was designed to describe elements of the processes and outcomes of care for OIF/OEF veterans in a VHA chiropractic clinic. A retrospective review of consecutive cases consulted to one VHA chiropractic clinic was conducted. Thirty-one cases were identified. Consultations originated in primary care and specialty clinics that commonly manage musculoskeletal conditions. Military traumatic injury and posttraumatic stress disorder were common. Adverse effects of treatment were mild and transitory. In 19 cases (61%), a pain decrease above the threshold for minimally important change was reported. This article is the first description of health services delivered to OIF/OEF veterans in a VHA chiropractic clinic. Chiropractic management was safe in these cases, and results support the hypothesis that such management may be effective in certain OIF/OIF veterans. A better understanding of the characteristics of these particular patients and the processes of care received in VHA chiropractic clinics is needed to improve the clinical care of these veterans.

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“…29 There is insufficient evidence for or against manipulation in patients with radiculopathy, but anecdotal evidence is in favour. Many dramatic recoveries have been described.…”

Section: Spinal Manipulationmentioning

confidence: 99%

The management of acute low back pain in adults: a guide for the primary care physician, Part II

Brighton

2013

South African Family Practice

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When a patient presents with acute low back pain (LBP), any red flag warnings of serious disease should first be excluded. Yellow and blue flag warnings of psychological factors should be noted. A psychological opinion of patients with substantial psychological distress could be sought. Advice may be offered on the benign nature of non-specific LBP. The person should be encouraged to be physically active and to continue with normal activities as far as possible. A structured exercise programme, that includes aerobic activity, movement instruction, muscle strengthening, postural control and stretching, should be devised. A combined exercise and psychological treatment programme that includes a cognitive behavioural approach can be considered in patients with significant disability or substantial psychological distress. A course of acupuncture may also be added. Manual therapy, including spinal manipulation, could be considered. Paracetamol should be the first medication option. If this is inadequate, a nonsteroidal anti-inflammatory drug or weak opioid, or both, can be added. Individual risks for side-effects and the patient's preference should be taken into account. Strong opioids should be considered in patients in severe pain, but for short-term use only. Antidepressants and gabapentine or pregabolin can be considered when there is a neurogenic component of the pain. Consider obtaining a surgical opinion on patients who have completed an optimal package of care and who still have persistent severe non-specific LBP. Progressive neurological fallout requires a surgical opinion.Peer reviewed.

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Evidence-informed management of chronic low back pain with spinal manipulation and mobilization

Cited by 152 publications

References 73 publications

The Effect of Cervical Spine Manipulation on Postural Sway in Patients With Nonspecific Neck Pain

The Effect of Cervical Spine Manipulation on Postural Sway in Patients With Nonspecific Neck Pain

Management of Operation Iraqi Freedom and Operation Enduring Freedom veterans in a Veterans Health Administration chiropractic clinic: A case series

The management of acute low back pain in adults: a guide for the primary care physician, Part II

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