• Chang-Yu J Hsieh, Alan H Adams, Jerome Tobis, Chang-Zern Hong, Clark Danielson, Katherine Platt, Fred Hoehler, Sibylle Reinsch, and Arthur Rubel.
• Research Division; and Professional Affairs, Los Angeles College of Chiropractic, Southern California University of Health Sciences, Whittier, California, USA. jhsieh@ix.netcom.com
• Spine. 2002 Jun 1; 27 (11): 1142-8.

Study DesignA randomized, assessor-blinded clinical trial was conducted.ObjectiveTo investigate the relative effectiveness of three manual treatments and back school for patients with subacute low back pain.Summary Of Background DataLiterature comparing the relative effectiveness of specific therapies for low back pain is limited.MethodsAmong the 5925 inquiries, 206 patients met the specific admission criteria, and 200 patients randomly received one of four treatments for 3 weeks: back school, joint manipulation, myofascial therapy, and combined joint manipulation and myofascial therapy. These patients received assessments at baseline, after 3 weeks of therapy, and 6 months after the completion of therapy. The primary outcomes were evaluated using visual analog pain scales and Roland-Morris activity scales.ResultsAll four groups showed significant improvement in pain and activity scores after 3 weeks of care, but did not show further significant improvement at the 6-month follow-up assessment. No statistically significant between-group differences were found either at the 3-week or 6-month reassessments.ConclusionsFor subacute low back pain, combined joint manipulation and myofascial therapy was as effective as joint manipulation or myofascial therapy alone. Additionally, back school was as effective as three manual treatments.

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