Controlled trial of mobilisation and manipulation for low back pain: hospital patients

Ninety-four patients with non-specific lumbar pain referred to hospital rheumatology and orthopaedic clinics participated in a double-blind controlled trial comparing mobilisation and manipulation with placebo physiotherapy. Results were assessed immediately after the tratment course, two months later, and at one year. Many patients showed improvement, but in contrast to a study on general-practitioner patients with nonspecific back pain no definite advantage could be associated with mobilisation and manipulation. The benefits of mobilisation and manipulation for low back pain are probably restricted to hastening recovery in patients likely rapidly to improve spontaneously. Hence patients whose severity and duration of symptoms warrant specialist referral are less likely to benefit from the technique.