The effectiveness of manual therapy, physiotherapy and treatment by the general practitioner for nonspecific back and neck complaints

Author(s): Bouter, L., van, M. , H, Essers, A., Verstegen, G., Hofbuizen, D., Houben, J., Knipschild, P.

Journal/Book: Spine. 1992; 17: 28-35.

Abstract: In a randomized trial, the effectiveness of manual therapy, physiotherapy, continued treatment by the general prac-titioner, and placebo therapy (detuned ultrasound and detuned short-wave diathermy) were compared for pa-tients (n = 256) with nonspecific back and neck com-plaints lasting for at least 6 weeks. The principle outcome measures were severity of the main complaint, global perceived effect, pain, and functional status. These are presented for 3, 6, and 12 weeks follow-up. Both physio-therapy and manual therapy decreased the severity of complaints more and had a higher global perceived effect compared to continued treatment by the general practi-tioner. Differences in effectiveness between physiotherapy and manual therapy could not be shown. A substantial part of the effect of manual therapy and physiotherapy appeared to be due to nonspecific (placebo) effects.

Keyword(s): randomized clinical trial

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