Research: GILES and MULLER,

Listed in Issue 100


GILES and MULLER, National Unit for Multidisciplinary Studies of Spinal Pain, The University of Queensland, The Townsville Hospital, Australia,, have carried out a randomized clinical trial comparing medication, acupuncture, and spinal manipulation for chronic spinal pain.


Because the value of both medicinal and alternative forms of treatment for chronic spinal pain is uncertain, a trial was conducted comparing medication with acupuncture and spinal manipulation.


115 patients with spinal pain of more than 3 months duration were enrolled in this randomized controlled trial and randomized to 3 groups to receive either medication, acupuncture, or chiropractic spinal manipulation. Oswestry Disability Questionnaire, Neck Disability Index, SF-36 questionnaire, Pain VAS, and range of movements were assessed pre treatment and again at 2, 5, and 9 weeks after treatment.


The highest proportion of recovery was found for chiropractic (27.3%), followed by acupuncture (9.4%) and medication (5%). Chiropractic achieved the best overall results, except that on the VAS for neck pain, acupuncture did better.


The study provides evidence that spinal manipulation can benefit patients with chronic spinal pain if it is not contraindicated. However the data do not strongly support the use of spinal manipulation only for these conditions. More research is needed, especially on combinations of therapies.


Giles LGF, Muller R. Chronic spinal pain: a randomized clinical trial comparing medication, acupuncture, and spinal manipulation. Spine 28 (14): 1490-1502, Jul 2003.

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