Journal of manipulative and physiological therapeutics
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J Manipulative Physiol Ther · Oct 1998
Randomized Controlled Trial Clinical TrialThe efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache.
Migraine headache affects approximately 11 million adults in the United States. Spinal manipulation is a common alternative therapy for headaches, but its efficacy compared with standard medical therapies is unknown. ⋯ There was no advantage to combining amitriptyline and spinal manipulation for the treatment of migraine headache. Spinal manipulation seemed to be as effective as a well-established and efficacious treatment (amitriptyline), and on the basis of a benign side effects profile, it should be considered a treatment option for patients with frequent migraine headaches.
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J Manipulative Physiol Ther · Sep 1998
Randomized Controlled Trial Clinical TrialAn investigation of the interrelationship between manipulative therapy-induced hypoalgesia and sympathoexcitation.
To investigate a proposed model in which manipulative therapy produces a treatment-specific initial hypoalgesic and sympathoexcitatory effect by activating a descending pain inhibitory system. The a priori hypothesis tested was that manipulative therapy produces mechanical hypoalgesia and sympathoexcitation beyond that produced by placebo or control. Furthermore, these effects would be correlated, thus supporting the proposed model. ⋯ Manual therapy produces a treatment-specific initial hypoalgesic and sympathoexcitatory effect beyond that of placebo or control. The strong correlation between hypoalgesic and sympathoexcitatory effects suggests that a central control mechanism might be activated by manipulative therapy.
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J Manipulative Physiol Ther · Nov 1996
Randomized Controlled Trial Comparative Study Clinical TrialTrunk exercise combined with spinal manipulative or NSAID therapy for chronic low back pain: a randomized, observer-blinded clinical trial.
To study the relative efficacy of three different treatment for chronic low back pain (CLBP). Two preplanned comparisons were made: (a) Spinal manipulative therapy (SMT) combined with trunk strengthening exercises (TSE) vs. SMT combined with trunk stretching exercises, and (b) SMT combined with TSE vs. nonsteroidal anti-inflammatory drug (NSAID) therapy combined with TSE. ⋯ Each of the three therapeutic regimens was associated with similar and clinically important improvement over time that was considered superior to the expected natural history of long-standing CLBP. For the management of CLBP, trunk exercise in combination with SMT or NSAID therapy seemed to be beneficial and worthwhile. The magnitude of nonspecific therapeutic (placebo) effects, cost-effectiveness and relative risks of side effects associated with these types of therapy need to be addressed in future studies.
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J Manipulative Physiol Ther · May 1996
Comment Letter Randomized Controlled Trial Clinical TrialSpinal manipulation vs. amitriptyline for the treatment of chronic tension headache: a randomized clinical trial.
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J Manipulative Physiol Ther · Mar 1995
Randomized Controlled Trial Comparative Study Clinical TrialSpinal manipulation vs. amitriptyline for the treatment of chronic tension-type headaches: a randomized clinical trial.
To compare the effectiveness of spinal manipulation and pharmaceutical treatment (amitriptyline) for chronic tension-type headache. ⋯ The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches. Amitriptyline therapy was slightly more effective in reducing pain at the end of the treatment period but was associated with more side effects. Four weeks after the cessation of treatment, however, the patients who received spinal manipulative therapy experienced a sustained therapeutic benefit in all major outcomes in contrast to the patients that received amitriptyline therapy, who reverted to baseline values. The sustained therapeutic benefit associated with spinal manipulation seemed to result in a decreased need for over-the-counter medication. There is a need to assess the effectiveness of spinal manipulative therapy beyond four weeks and to compare spinal manipulative therapy to an appropriate placebo such as sham manipulation in future clinical trials.