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Study Compares Ways of Treating Low Back Pain

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Press Release Date: October 7, 1998

A comparison of methods of treating low back pain supported by the federal Agency for Health Care Policy and Research (AHCPR) found no significant differences in outcomes among patients who were either treated by chiropractic spinal manipulation, a popular form of physical therapy called the McKenzie method, or simply given an educational booklet and not treated.

According to the study in the October 8 New England Journal of Medicine, the chiropractic and McKenzie physical therapy patients were much more satisfied with their treatment than were the patients given the booklet. However, the short-term pain relief experienced by the chiropractic and McKenzie physical therapy patients was only marginally better than that of the no treatment group. Furthermore, there were no significant differences among the three groups at any of the follow-up points (1, 4, 12 and 52 weeks after initial treatment) in their ability to function or in disability—days spent in bed, home from work or school, or cutting down on usual activities. In addition, neither chiropractic manipulation of the spine nor McKenzie physical therapy reduced recurrence of back pain, subsequent visits, or costs of back care.

The study was based on 321 adult low back pain patients aged 20 to 64 seen in a primary care clinic who were randomly selected to undergo spinal manipulation by a chiropractor, see a physical therapist for McKenzie therapy, or simply be given a booklet. The study was led by Daniel C. Cherkin, Ph.D., of the Group Health Center for Health Studies—the research arm of the Group Health Cooperative of Puget Sound—a large health maintenance organization. Dr. Cherkin is also affiliated with the departments of health services and family medicine of the University of Washington, Seattle.

For detailed findings and conclusions, see "A Comparison of Physical Therapy, Chiropractic Manipulation and Provision of an Educational Booklet for Treatment of Patients with Low Back Pain." The study is one of several funded by AHCPR to examine the effectiveness and cost-effectiveness of the various ways used to treat low back pain—a problem that may affect up to half of all Americans in any given year and costs an estimated $50 billion to $100 billion annually, half of which goes to direct medical care.

Select for more information about AHCPR outcomes research.

Note to Editors: The press officer for the Group Health Cooperative of Puget Sound, Karen Szabo, can be reached by calling (206) 448-4148.

For additional information, please contact AHCPR Public Affairs: Karen Migdail, (301) 427-1855 (; Salina V. Prasad, (301) 427-1864 (

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