In the short term, patients who received chiropractic care coupled with home exercise and advice reported greater reductions in back-related leg pain (BRLP) than those who received home exercise advice alone, according to a study being published in Annals of Internal Medicine. BRLP, such as sciatica, is often disabling and causes more work loss, medication use, and health-related costs than uncomplicated low back pain. Managing BRLP is complicated because there is little evidence to guide treatment decisions. Most patients with BRLP are treated with medications and injections, which raises concerns about overuse and safety.
In a controlled trial, researchers randomly assigned 192 adults with subacute or chronic BRLP to either 12 weeks of chiropractic therapy plus home exercise and advice or home exercise and advice alone. Patients in the chiropractic plus exercise group were allowed up to 20 chiropractic visits during the 12-week trial. Home exercise and advice included in-person instructions on how to perform positioning and stabilization exercises and how often to do them, as well as telephone and e-mail follow up from providers. At 12 weeks, patients in the chiropractic and home exercise and advice group reported greater improvements in pain and function than those in the exercise and advice alone group. At one year, differences between groups were no longer present, except in some secondary outcomes.
Research: Spinal Manipulation and Home Exercise With Advice for Subacute and Chronic Back- Related Leg Pain: A Trial With Adaptive Allocation, G. Bronfort, M.A. Hondras, C.A. Schulz, R.L. Evans, C.R. Long, and R. Grimm, Annals of Internal Medicine, published 15 September 2014.