Low back pain is virtually a given for the majority of us, with studies showing that almost everyone will experience an episode, and some will have a recurring or longstanding problem. Now comes hope, as Rick and I discuss on PodMed this week and published in JAMA, in the form of a meta-analysis taking a look at spinal manipulation, or chiropractic, in improving pain.
Participants in these trials who were included in the analysis had acute, lower back pain of less than or equal to 6 weeks duration. Spinal manipulation therapy was able to reduce pain moderately and for up to six weeks, about the same as using a non-steroidal anti-inflammatory medication. As Rick opines, that's pretty good as it avoids the harms associated with medications. What about the harms of spinal manipulation? The study found that such harms were transient and musculoskeletal in nature. On the detraction side is also the fact that chiropractic costs more than simply popping an OTC medicine. On the whole, however, the evidence tilts the scales in favor of attempting spinal manipulation, with Rick confiding that he has referred patients for this treatment with favorable results.
Other topics this week include The US Preventive Services Task Force 2017 Draft Recommendation Statement on Screening for Prostate CancerAn Invitation to Review and Comment, also in JAMA and which Rick encourages everyone to read and comment on, and from NEJM, Mortality and Cardiovascular Disease in Diabetes and Incidence Trends of Diabetes among Youths. Until next week, y'all live well.