Research: GILES and MULLER,

Listed in Issue 49


GILES and MULLER, National Unit for Multidisciplinary Studies of Spinal Pain, Townsville General Hospital, Queensland, Australia compared needle acupuncture, drug medication and spinal manipulation for the management of chronic spinal pain .



the authors conducted a prospective, randomised, independently assessed preintervention and postintervention clinical pilot trial at a specialised out-patient unit in Queensland Australia. 77 patients, without contraindication to manipulation or medication (tenoxicam with ranitidine) were recruited into the pilot study. The interventions consisted of one of three: needle acupuncture, nonsteroidal anti-inflammatory medication, or chiropractic spinal manipulation. The main outcome measures were changes after 4 weeks following the initial visit in the scores of the: 1) Oswestry Back Pain Disability Index; 2) Neck Disability Index, and 3) three visual analogue scales of local pain intensity.


Randomisation was successful. Following the median intervention period of 30 days, spinal manipulation was the only intervention which achieved statistically significant improvements as follows: 1) Reduction of 30.7% on the Oswestry scale: 2) Improvement of 25% on the neck disability index; and 3) Reductions on the visual analogue scale of 50% for low back pain, 46% for upper back pain and 33% for neck pain. None of the other interventions demonstrated any significant improvement on any of the outcome measures.


Despite several discussed shortcomings of this pilot study, the results demonstrate that for patients with chronic spinal pain syndromes, spinal manipulation, if not contraindicated, results in greater improvement than acupuncture and drug therapy.


Giles LG and Muller R. Chronic spinal pain syndromes: a clinical pilot trial comparing acupuncture, a nonsteroidal anti-inflammatory drug, and spinal manipulation. Journal of Manipulative and Physiological Therapeutics 22(6): 376-81. Jul-Aug 1999.

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