This article discusses the methodology of a recently published British randomized clinical trial comparing chiropractic and physiotherapy for the treatment of low back pain. The authors base their main conclusions on a difference shown by the Oswestry pain questionnaire 2 years after randomization, when data on only 26% of the patients were available. This might have led to an overestimate, because it appears that the difference in Oswestry scores is much larger for patients enrolled in the study early. It is also uncertain whether the magnitude of the effect reported really indicates a clinically significant difference between the interventions. In addition to the intervention, the groups differ in duration of treatment, number of sessions, level of experience of the therapist and health care setting. The results are difficult to extrapolate, because only a small portion of the eligible patients took part, and chiropractic seems to be clearly superior only in the subgroup originally presenting at a chiropractic clinic. We conclude that it is premature to draw conclusions on the long-term effectiveness of chiropractic on the basis of the results of this study alone.
|Translated title of the contribution||Effectiveness of chiropractic and physiotherapy in low back pain. A critical discussion of the British randomized clinical trial|
|Number of pages||5|
|Publication status||Published - 1 Jan 1993|
- comparative study
- outpatient clinics
- random allocation