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Chiropractic Research Review

Evaluating Traditional Bone-Setting

Strenuous exercise, chiropractic adjustments, and psychosocial treatment are all treatment options for nonspecific low back pain (LBP), although which method is best remains unproven. Bone-setting is considered a form of manipulation from which modern manual treatment methods, such as chiropractic and osteopathy, evolved.

This study tested bone-setting and light exercise therapy against physiotherapy.

In this one-year study, 114 patients with back pain of at least seven weeks duration were randomly assigned to one of three groups, based on treatment: bone-setting (by four traditional healers using their own preferred methods), nonmanipulative physiotherapy, or light exercise. Up to 10 treatment sessions were allowed over a six-week period; Oswestry Disability Questionnaire scores at the end of the treatment and at three, six, and 12 months were the primary outcome measures. Sick leave and health-center visits were also considered (one year before and after treatment).

The bone-setting group showed the highest improvement in Oswestry disability scores for each questionnaire up to and including one year; an analysis of additional therapies used after intervention showed a "possible subgroup with an enhanced effect from bone-setting." Only the physiotherapy patients showed a decrease in health-center visits for their back pain. Sick leave did not vary significantly between groups.

Conclusion: Bone-setting may be more effective than light exercise or physiotherapy for back pain, according to the authors. They write, "The mere survival of this tradition merits an attempt to explain its possible mechanisms of action."

Hemmilä HM, Keinänen-Kiukaanniemi SM, Levoska S, et al. Long-term effectiveness of bone-setting, light exercise therapy, and physiotherapy for prolonged back pain: A randomized controlled trial. Journal of Manipulative and Physiological Therapeutics 2002:25(2), pp. 99-104.

Chiropractic Research Review

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