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Does folk medicine work? A randomized clinical trial on patients with prolonged back pain
H M Hemmilä1, S M Keinänen-Kiukaanniemi, S Levoska
1Folk Medicine Centre, Kaustines, Finland.
Objective:
To determine whether traditional bone-setting or continuous light exercise therapy could case back pain and improve function better than ordinary physiotherapy.
Design:
Observer-blinded, randomized clinical trial with a 6-month follow-up.
Setting:
An outpatient institution for folk medicine research.
Patients:
Of 147 back pain patients recruited from local health centers and by newspaper announcements, 132 were found eligible (non-retired-no contraindications to manipulation) and entered. A final 114 (one dropout) with back pain for longer than 7 weeks were included in this intent to treat analysis.
Interventions:
Bone-setting, guidance for continuous light back movements or physiotherapy for up to ten 1-hour sessions during 6 weeks.
Main Outcome Measures:
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 by exercise but not better than by physiotherapy.
Conclusion:
Neither bone-setting nor exercise differed significantly from physiotherapy, but bone-setting improved lateral and forward bending of the spine and back pain more than did exercise.