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Spinal Manipulation Eases Back-Related Leg Pain

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Patients suffering from leg pain related to back problems can experience a great deal of discomfort, yet this is an area with little research to guide management of the condition.

A new study, published in the Annals of Internal Medicine, seeks to fill that void.

Researchers in the United States wanted to find out whether manipulation of the spine was effective in helping to reduce leg pain in the short and long term. They enrolled 192 patients, of whom 191 (99%) provided follow-up data at 12 weeks and 179 (93%) did the same at 52 weeks.

All patients were adults aged 21 or older and had experienced back-related leg pain for least four weeks. They were given 12 weeks of treatment which took the form of either spinal manipulative therapy plus home exercise and advice, or home exercise and advice alone.

The primary outcome was back-related leg pain as rated by the patient at 12 and 52 weeks, while secondary outcomes included self-reported low back pain, disability, global improvement, satisfaction, medication use and general health status at 12 and 52 weeks.

Results showed that patients who received spinal manipulation had more short-term relief. Their leg pain at 12 weeks was rated 10 percentage points lower, a difference that the researchers said was “clinically important.” Over the longer term that advantage disappeared, but the scores for secondary outcomes remained higher for the patients in the spinal manipulation group.

There were benefits, too, for the patients who were given only home exercise and advice. Almost half of them experienced a 50% reduction in leg pain symptoms in both the short and long term.

Commenting on this finding, Gert Bronfort, who led the study, told Reuters Health: “That´s an important improvement and warrants future research. We look forward to investigating how home exercise alone may compare to usual medical treatment and/or no treatment at all.”