DOES FOLK MEDICINE WORK - A RANDOMIZED CLINICAL-TRIAL ON PATIENTS WITH PROLONGED BACK PAIN

Objective: To determine whether traditional bone-setting or continuous light exercise therapy could ease back pain and improve function bett er than ordinary physiotherapy. Design: Observer-blinded, randomized c linical trial with a 6-month follow-up. Setting: An outpatient institu tion for folk medicine research. Patients: Of 147 back pain patients r ecruited from local health centers and by newspaper announcements, 132 were found eligible (non-retired, no contraindications to manipulatio n) and entered. A final 114 (one dropout) with back pain for longer th an 7 weeks were included in this intent to treat analysis. Interventio ns: Bone-setting, guidance for continuous light back movements or phys iotherapy for up to ten 1-hour sessions during 6 weeks. Main Outcome M easures: Spinal mobility and muscular performance. Back pain assessed by visual analog scales (VAS). Results: The physical measures changed only modestly, from one tenth to half of standard deviation, while the VAS was halved. The thoracolumbar side-bending, the modified Schober, and the VAS were significantly better improved by bone-setting than b y exercise but not better than by physiotherapy. Conclusion: Neither b one-setting nor exercise differed significantly from physiotherapy, bu t bone-setting improved lateral and forward bending of the spine and b ack pain more than did exercise. (C) 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.