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 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.