Chiropractic manipulation in the treatment of XXXX and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations.

@entity1 @entity615 @entity158
BACKGROUND CONTEXT: @entity615 and sciatica are major sources of disability. Many medical interventions are available, including manipulations, with conflicting results. PURPOSE: To assess the short- and long-term effects of spinal manipulations on @entity615 and sciatica with disc protrusion. STUDY DESIGN/SETTING: Randomized double-blind trial comparing active and simulated manipulations in rehabilitation medical centers in Rome and suburbs. @entity1 SAMPLE: 102 ambulatory @entity1 with at least moderate @entity158 on a visual analog scale for @entity158 (VAS1) and/or radiating @entity158 (VAS2). OUTCOME MEASURES: @entity158 -free @entity1 at end of treatment; treatment failure (proportion of @entity1 stopping the assigned treatment for lack of effect on @entity158 ); number of days with no, mild, moderate, or severe @entity158 ; quality of life; number of days on nonsteroidal anti-inflammatory drugs; number of drug prescriptions; VAS1 and VAS2 scores; quality of life and psychosocial findings; and reduction of disc protrusion on magnetic resonance imaging. METHODS: Manipulations or simulated manipulations were done 5 days per week by experienced chiropractors, with a number of sessions which depended on @entity158 relief or up to a maximum of 20, using a rapid thrust technique. @entity1 were assessed at admission and at 15, 30, 45, 90, and 180 days. At each visit, all indicators of @entity158 relief were used. RESULTS: A total of 64 @entity1 and 38 @entity1 aged 19-63 years were randomized to manipulations (53) or simulated manipulations (49). Manipulations appeared more effective on the basis of the percentage of @entity158 -free cases ( @entity158 28 vs. 6%; p<.005; radiating @entity158 55 vs. 20%; p<.0001), number of days with @entity158 (23.6 vs. 27.4; p<.005), and number of days with moderate or severe @entity158 (13.9 vs. 17.9; p<.05). @entity1 receiving manipulations had lower mean VAS1 (p<.0001) and VAS2 scores (p<.001). A significant interaction was found between therapeutic arm and time. There were no significant differences in quality of life and psychosocial scores. There were only two treatment failures (manipulation 1; simulated manipulation 1) and no adverse events. CONCLUSIONS: Active manipulations have more effect than simulated manipulations on @entity158 relief for @entity615 and sciatica with disc protrusion.
