Chronic low back pain: a study of the effects of manipulation under anesthesia
Structural and chiropractic
J Manipulative Physiol Ther.2002 Oct;25(8):E8-E17.
N F Palmieri, S Smoyak
Objective: The objective of this project was to evaluate the efficacy of using self-reported questionnaires to study manipulation under anesthesia (MUA) for patients with chronic low back pain. Self-reported outcome assessment instruments were used to evaluate changes in patients receiving MUA versus those not receiving MUA. Setting: Two ambulatory surgical centers and 2 chiropractic clinics. Subjects: A total of 87 subjects participated in this study. The intervention group consisted of 38 patients and the nonintervention group consisted of 49 patients. Selection was made from a convenience sample of patients selected from doctors who perform MUA at 2 centers participating in the study. Intervention: Patients in the intervention group received MUA. Patients in the nonintervention group received traditional chiropractic treatment. Outcome measures: A Numeric Pain Scale and the Roland-Morris Questionnaire were administered at baseline evaluation, after the procedure, and 4 weeks later. Results were documented and compared. Results: The average Numeric Pain Scale scores in the MUA group decreased by 50%, and the average Roland-Morris Questionnaire scores decreased by 51%. The average Numeric Pain Scale changes in the nonintervention group decreased by 26%, and in the Roland-Morris Questionnaire group mean scores decreased by 38%. Conclusions: In this sample of patients with chronic low back pain, self-reported outcomes improved after the procedure and at follow-up evaluation. There was more improvement reported in the intervention group than the nonintervention group. This study supports the need for large-scale studies on MUA. It also revealed that self-reported outcome assessments are easily administered and a dependable method to study MUA.