Comparative Clinical Trial: Manual Therapy With and Without Radial Extracorporeal Shockwave Therapy to Treat Acute Low Back Pain

Northeast College of Health Sciences

Status: Enrolling

Conditions: Acute Lower Back Pain

Treatments: Other: Chiropractic Care; Other: Radial Extracorporeal Shockwave Therapy (ESWT) - Radial Pulse Therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT06852898

24-08

Details and patient eligibility

About

The goal of this clinical trial is to learn if the addition of radial pulse therapy to chiropractic care will help adult patients recover faster to an acute bout of low back pain. Radial pulse therapy is the application of acoustic waves that passes through the skin to tissues and cells in the body. The main questions that the clinical trial aims to answer are:

• Does the addition of radial pulse therapy to chiropractic care result in better or earlier reduction in pain intensity?
• Does the addition of radial pulse therapy to chiropractic care result in better or earlier improvement in physical function?

Researchers will compare radial pulse therapy plus chiropractic care to chiropractic care alone to see if patients with acute low back pain recover faster with the addition of radial pulse therapy.

Participants will:

• Visit the clinic once a week for 5 weeks
• Receive chiropractic care with or without the addition of radial pulse therapy to the low back and hip regions of the body
• Report their pain intensity and perform a physical function test at each clinic visit

Enrollment: 60 estimated patients

Sex: All

Ages: 18 to 40 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Biological sex of male or female
2. Age Range: 18 to 40 years old
3. Diagnosis of acute mechanical low back pain (< 3 months duration)
4. Pain intensity > 3 on the 11 point NPRS with 0 "being no pain at all" to 10 "being worse pain possible" within the context of either "right now" or "at its worst during the past 7 days"

Exclusion criteria

1. Subjects who are currently using over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil, Motrin) and naproxen (Aleve), or prescription NSAIDs to manage any medical condition.

2. Subjects who used oral corticosteroids that are only available by prescription to manage any medical condition within the past 6 weeks.

3. Subject who received a corticosteroid injection for any medical condition within the past 6 weeks.

4. Subjects who are not willing to be randomly assigned to either of the treatment interventions.

5. Subjects with open wounds to the lower and mid back that will prevent the application of radial ESWT.

6. Subjects with hypermobility and/or instability of the lower and mid back, which are contraindications for manual therapy.

7. Subjects who have a case history of low back pain episodes, e.g., chronic or persistent occurrence of low back pain.

8. Subjects who do not meet the differential diagnosis of acute mechanical low back pain, i.e., origin of their back pain is unknown or non-specific to a low back structure.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 2 patient groups

Chiropractic Care Only

Active Comparator group

Description:

1. The treating clinician will use soft tissue palpation procedures applied to hips, pelvis / buttocks low back and mid back to identify taut and tender regions for manual therapy, e.g., trigger points that the clinician identified during soft tissue palpations. 2. The treating clinician will use soft tissue treatment procedures, e.g., applying precise pressure to trigger points and manual stretching techniques, to relieve taut and tender regions that were identified during soft tissue palpation procedures. 3. The treating clinician will perform high velocity, low amplitude (HVLA) spinal adjustments to restricted areas of the mid back, lower back, and hips regions.

Treatment:

Other: Chiropractic Care

Chiropractic Care Plus Radial Pulse Therapy

Experimental group

Description:

Chiropractic Care is the same as described for the active comparator arm. After receiving chiropractic care, the subject receives radial extracorporeal shockwave therapy (ESWT). The treating clinician places the ESWT probe over the treatment areas in the mid back, low back, and hip regions. At each clinic visit, there are up to six treatment areas for ESWT. At each treatment area, the subject receives 2000 radial pulses at frequency of 10 Hz (single pulse every 100 ms or 10 pulses per second). The intensity of the radial pulses are comfortable for the subjects. Duration of ESWT at each treatment area is 200 seconds or 3.33 minutes.

Treatment:

Other: Radial Extracorporeal Shockwave Therapy (ESWT) - Radial Pulse Therapy

Other: Chiropractic Care