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Chiropractic Research Review

Traction/Massage vs. Interferential for LBP

Between 70-80% of adults are affected by low back pain (LBP) at some point in their lives, and although most episodes seem to be self-limiting, the incidence of recurrence and/or chronicity remains high.

A clear distinction between acute and chronic LBP can be difficult, in particular because of variations in intensity, duration and frequency of episodes. Chiropractors currently use a variety of mechanisms to manage low back pain, suggesting the need for studies such as this one to evaluate the efficacy of several other specific types of treatment.

To compare interferential therapy with motorized lumbar traction/massage in the management of LBP in a primary care setting, 152 patients were randomly assigned to receive one of the two interventions (six 10-minute sessions over a period of 14-21 days); 138 patients completed the study. Results revealed no significant differences in effectiveness between the two interventions based on Oswestry Disability Index (ODI) and 100-millimeter visual analog pain scale (VAS) scores.

The average ODI score before treatment was 30 for both groups; 25 after treatment; and at a three-month follow-up, 21 for the interferential group vs. 22 for the traction/massage group. Showing similar trends, VAS scores at baseline were 50 for the interferential group vs. 51 for the traction/massage group; after treatment and again three months later, scores were 46 vs. 44 and 42 vs. 39, respectively. For the VAS, 0 equalled no pain and 100 denoted unbearable pain.

These findings provide evidence that interferential therapy is no more or less effective than traction with massage. The authors point out that these results are significant in that "although there is evidence from several trials that traction alone is ineffective in the management of low back pain, (we) cannot conclude that traction with massage is ineffective." They recommend that practitioners who use interferential or lumbar traction therapy question the evidence on which their practice is based.

Werners R, Pynsent PB, Bulstrode JK. Randomized trial comparing interferential therapy with motorized lumbar traction and massage in the management of low back pain in a primary care setting. Spine, August 1, 1999:24(15), pp1579-1584.

Chiropractic Research Review

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