Manipulative therapy and/or NSAIDs for acute low back pain: design of a randomiz

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BMC Musculoskeletal Disorders 2005, 6:57 doi:10.1186/1471-2474-6-57

10 November 2005

Manipulative therapy and/or NSAIDs for acute low back pain: design of

a randomized controlled trial [ACTRN012605000036617]

Mark J Hancock , G Maher , Jane Latimer , J

McLachlan , W , O Day , F Spindler and

H McAuley

Abstract (provisional)

Background

Acute low back pain is a common condition resulting in pain and

disability. Current national and international guidelines advocate

general practitioner care including advice and paracetamol (4 g daily

in otherwise well adults) as the first line of care for people with

acute low back pain. Non-steroidal anti-inflammatory drugs (NSAIDs)

and spinal manipulative therapy (SMT) are advocated in many

guidelines as second line management options for patients with acute

low back pain who are not recovering. No studies have explored the

role of NSAIDs and/or SMT in addition to first line management for

acute low back pain. The primary aim of this study is to investigate

if NSAIDs and/or SMT in addition to general practitioner advice and

paracetamol results in shorter recovery times for patients with acute

low back pain. The secondary aims of the study are to evaluate

whether the addition of SMT and/or NSAIDs influences pain, disability

and global perceived effect at 1, 2, 4 and 12 weeks after onset of

therapy for patients with significant acute low back pain. Methods /

Design This paper presents the rationale and design of a randomised

controlled trial examining the addition of NSAIDs and/or SMT in 240

people who present to their general practitioner with significant

acute low back pain.