Effectiveness of spinal manipulative therapy for chronic low-back pain: Systematic review
Kholoud Abdulaziz AL-Homoud
Convalescent Hospital, KSA
: J Nurs Patient Care
Abstract
Background: Many treatments exist for Low-Back Pain (LBP). These include Spinal Manipulative Therapy (SMT), which is a universal and widely practiced intervention. Objective: To evaluate SMT effectiveness upon an individual’s pain and the functional status on long-term. Study Design: Systematic review. Methods: Search of multiple databases from June 2009 up to June 2017 for Randomized Controlled Trials (RCTs) studies. Two reviewers employed the Cochrane Collaboration’s tool for evaluation of bias probability in independent rating of the selected studies. Results: Three RCTs were included after applying the inclusion/exclusion criteria to the trials from the searched databases (total participants=698). Two of the included trials had a low risk of bias and one had a high risk of bias. There is a small significant effect of SMT on CLBP - immediate after session - but not clinically relevant, short-term effect on pain relief and functional status improvement in contrast with other interventions. Furthermore, data suggest that there were fewer recurrences of LBP, with significantly less use of pain-related drugs, in the SMT groups than in patients who had received physiotherapy. However, there were no significant long-term differences between SMT treatment and other common interventions. Conclusion: The trials included in this review did not demonstrate clinically significant on long-term pain and functional improvements in patients with CLBP after application of SMT. To maintain the improvements that were observed in the short term in many RCTs, Further research advocated ‘maintenance SMT’, whereby SMT is applied for more than six weeks. However, SMT requires availability of proficiently trained practitioners in the ambulatory setting. Therefore, if a practitioner wanted to use SMT for a patient with CLBP, this should be based on treatment costs, the preferences of the patient and practitioners and the relative safety of SMT.
Biography
Kholoud Abdulaziz AL-Homoud has completed her MSc from University of Salford, UK. She is a Senior Physiotherapist and the Director of Heath Education Department at Convalescent Hospital, KSA. She is a Member in Spine Society of Europe and Saudi Spine Society.
E-mail: kholoud.a-pt@hotmail.com
