Effects of Spinal Manipulation in Patients With Nonspecific Low Back Pain

Ignacio Alejandro Astudillo Ganora

Status: Completed

Conditions: Lumbar Pain Syndrome; Back Pain; Back Pain, Low

Treatments: Other: spinal manipulation + respiratory exercise; Other: Spinal manipulation + Kinesiotaping; Other: Spinal Manipulation + exercise program

Study type: Interventional

Funder types: Other

Identifiers

NCT05080374

3500/2021

Details and patient eligibility

About

Introduction: Nonspecific low back pain is the most common cause of visits to medical personnel and is the largest cause of absenteeism in the world. (1), Nonspecific low back pain accounts for 85% of low back pain, notably affecting quality of life and working life (2), There is a 50-70% probability that a person will have low back pain during their life ( 3), lumbago produces 300,000 years lived with disability (ADL), being the first burden of disease in Chile, surpassing hypertensive heart disease and depression (4). There are many therapeutic approaches to the management of nonspecific low back pain, including high-speed, low-amplitude spinal manipulations (5). This technique consists of applying a short and rapid force at the level of the joint that is restricted, in order to restore normal joint mobility. The physiological effects of manipulations are not sufficiently studied, but some authors (6) (7) suggest that the nervous system is the mediator of the effects of spinal manipulation. Among non-pharmacological interventions, numerous clinical guidelines recommend the use of therapeutic exercise for low back pain (8), including a wide variety of types of recommended exercises, the most traditionally recommended being aerobic exercises, exercises that involve stretching postures of the back. vertebral musculature, strengthening and strength exercises (9) and central stabilization exercises (10). Recently, the effects of inspiratory muscle and diaphragm training exercises in patients with low back pain are being investigated (11). The application of an elastic bandage (12) in the lumbar area generates a proprioceptive signal through the skin, producing analgesia and a feeling of support in the area.

Objectives: To compare the effects of different therapeutic approaches in combination with spinal manipulation.

Design and method: Single-blind randomized clinical trial Results: Significant differences are expected before and after treatment and differences between groups.

Conclusion: The aims of this study is to demonstrate that High speed and low amplitude spinal manipulation plus other conservative treatment is a valid therapeutic strategy for the management of nonspecific low back pain

Enrollment: 90 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• older than 18 years
• with nonspecific low back pain

Exclusion criteria

• chronic low back pain (more than 3 months)
• spinal surgeries
• red flags for spinal manipulation (osteoporosis, bone metastasis, etc)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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90 participants in 3 patient groups

HVLA + exercise Group

Experimental group

Description:

Spinal manipulation (HVLA) + trunk exercise program

Treatment:

Other: Spinal Manipulation + exercise program

HVLA + kinesiotaping group

Experimental group

Description:

Spinal manipulation (HVLA) + Kinesiotaping (lumbar)

Treatment:

Other: Spinal manipulation + Kinesiotaping

HVLA + Respiratory exercise group

Experimental group

Description:

Spinal manipulation (HVLA) + respiratory exercise program

Treatment:

Other: spinal manipulation + respiratory exercise