J Manipulative Physiol Ther. 2001 May; 24(4): 288-91.

Recovery pattern of patients treated with chiropractic spinal manipulative therapy for long-lasting or recurrent low back pain.

Stig LC, Nilsson Ã, Leboeuf-Yde C.

Private Practice, Arendal, Norway.

OBJECTIVE: To investigate the recovery pattern in chiropractic patients being treated for long-lasting or recurrent low back pain; in particular, to identify the minimum number of required treatments and the minimum number of days from the beginning of treatment to the occurrence of improvement. DESIGN: Prospective, uncontrolled multicenter study. SETTING: Private practice. PARTICIPANTS: Each of 19 selected Norwegian chiropractors provided 10 consecutive patients; each of the latter fulfilled a set of criteria (low back pain, a present episode longer than 2 weeks in duration, a total of more than 4 weeks of low back pain in the preceding year, no chiropractic treatment during the preceding 6 months, and suitability for manipulation). Response Rate: Data were collected on 164 patients (86% of the optimal study sample), 6 of whom were excluded. This left 158 patients for the analyses. Main Outcome Measures: Information on low back pain status was collected on each visit (maximum, 12 visits) through use of both a 10-point numeric pain rating scale and a global improvement scale (for the question "Do you feel that you have improved since you began receiving chiropractic treatment?," 5 answers were possible, ranging from "Yes, definite improvement" to "No, I am worse now than when the treatment started"). With respect to the numeric pain rating scale, "improvement" was defined as the point at which the score reached 2 for the first time or, if the initial score was 2, the point at which the score reached 1 for the first time. With respect to the global improvement scale, "improvement" was defined as the point at which the patient first answered "Yes, definite improvement." RESULTS: Approximately 50% of patients reported that they had "improved" at the 4th visit and within 2 weeks. After this time, fewer new cases of "improvement" occurred for every visit or day since the first treatment. At the 12th visit (earlier if treatment was concluded before the 12th visit), approximately 75% of the patients reported that "improvement" had occurred. CONCLUSION: There is a large group of chiropractic patients with relatively long-lasting or recurrent low back pain who report "improvement" early in the course of treatment.