Does folk medicine work? A randomized clinical trial on patients with prolonged back pain

Abstract

Objective: To determine whether traditional bone-setting or continuous light exercise therapy could case back pain and improve function better than ordinary physiotherapy.

Design: Observer-blinded, randomized clinical trial with a 6-month follow-up.

Setting: An outpatient institution for folk medicine research.

Patients: Of 147 back pain patients recruited from local health centers and by newspaper announcements, 132 were found eligible (non-retired-no contraindications to manipulation) and entered. A final 114 (one dropout) with back pain for longer than 7 weeks were included in this intent to treat analysis.

Interventions: Bone-setting, guidance for continuous light back movements or physiotherapy for up to ten 1-hour sessions during 6 weeks.

Main outcome measures: Spinal mobility and muscular performance. Back pain assessed by visual analog scales (VAS).

Results: The physical measures changed only modestly, from one tenth to half of standard deviation, while the VAS was halved. The thoracolumbar side-bending, the modified Schober, and the VAS were significantly better improved by bone-setting than by exercise but not better than by physiotherapy.

Conclusion: Neither bone-setting nor exercise differed significantly from physiotherapy, but bone-setting improved lateral and forward bending of the spine and back pain more than did exercise.