Scand J Prim Health Care. 1993 Jun; 11(2): 83-90.

Manual therapy with steroid injections in low-back pain. Improvement of quality of life in a controlled trial with four months' follow-up.

Blomberg S, Svärdsudd K, Tibblin G.

Department of Family Medicine, Uppsala University, Sweden.

OBJECTIVE--To compare prospectively the effect of manual treatment such as manipulation, specific mobilization, muscle stretching, auto-traction, and cortisone injections with standardized conventional but optimized activating treatment by primary health care teams. DESIGN--Prospective controlled multicentre trial with four months' follow-up. SETTING--Kopparberg County, Sweden. Six primary health care or occupational health care centres, representing a catchment area of 56000 residents participated. PARTICIPANTS--101 outpatients with acute or subacute low-back pain were, during the period February 1988 to April 1989, randomly allocated to one of two treatment groups. MAIN OUTCOME MEASURE--Quality of life was assessed at baseline and at four months by means of visual analogue scales (VAS). The occurrence of 27 different symptoms of a psychosomatic character was surveyed initially and at four months by questions answered by "yes" or "no" in a questionnaire. RESULTS--There were significant differences concerning quality of life and presence of general symptoms in favour of the group receiving manual treatment with steroid injections. CONCLUSION--Manual treatment with steroid injections was superior to conventional treatment in minimizing mental and somatic symptoms and increasing quality of life, in parallel with other measures of improvement.