Assessment of diclofenac or spinal manipulative therapy, or both, in addition to recommended first-line treatment for acute low back pain: a randomised controlled trial

Hancock M, Maher C, Latimer J, McLachlan A, Cooper C, O.Day R , Spindler M, McAuley J

This study looked at 240 patients with acute low back pain of less than 6 weeks duration. They were divided into four groups. Diclofenac and placebo manipulative therapy, spinal manipulative therapy and placebo diclofenac, diclofenac and manipulation or double placebo. The primary outcome measure used was days until recovery. The secondary outcome measures used were pain, function and disability (Using the Roland Morris Outcome measure). The results showed no difference between any of the groups.
The authors concluded that patients with acute low back pain already having recommended first line care do not recover more quickly with the addition of diclofenac or manipulative therapy.

The Lancet, vol. 370, p. 1638.

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