Spinal Manipulation or Muscle Relaxants?

Most patients suffering with acute mild or moderate low back pain recover in a short period of time using over-thecounter medications, heat or cold packs and maintenance of most of their usual activities. But many of those who have greater pain and dysfunction visit health care professionals. (You should contact your doctor if you have any of the following warning signs along with your back pain: loss of bowel or bladder control, leg weakness, fever, or pain when coughing or urinating.) Patients should be aware that different approaches yield very different results when it comes to back pain.

A multi-disciplinary research team conducted a randomized, double-blind clinical trial to compare the effectiveness of spinal manipulation with muscle relaxants and placebo for low back pain. Patients experiencing low back pain of 2 to 6 weeks' duration were randomly allocated to one of 3 groups with interventions applied over 2 weeks. Interventions were either spinal manipulations with placebo medicine, muscle relaxants with sham adjustments, or placebo medicine with sham manipulations.

At the end of the trail, spinal manipulation was 51% more beneficial than placebo and muscle relaxants in reducing pain. Spinal manipulation was 62% more beneficial than muscle relaxants in improving function. In fact, muscle relaxants failed to do better than placebo for improving function.

Previous research agrees with this current study. The American Pain Society and the American College of Physicians commissioned an evidence-based review of the scientific literature to advise health care professionals and patients how best to manage low back pain and disability. The results from this panel's research were published in Annals of Internal Medicine. It is interesting to note that manipulation was the only therapy that demonstrated effectiveness for all patient groups (acute, chronic, sciatica).

Moreover, muscle relaxants are associated with several serious adverse events. There is an increased risk for heart failure, paralysis, difficulty breathing, tachycardia, sudden numbness or weakness, confusion, problems with vision, speech, or balance, fainting, lack of coordination, unusual thoughts or behavior, and hallucinations. In contrast, adverse effects associated with low back manipulation are minimal. Muscle soreness is common, but is usually short-lived and mostly mild to moderate in severity, similar to home exercise in both severity and frequency.

Dr. Tom Honka is a chiropractor specializing in the non-surgical treatment of spinal conditions. His clinic is located in Porterville. Call 781-2222 for more information.