Long-term effectiveness of bone-setting, light exercise therapy, and physiotherapy for prolonged back pain:: A randomized controlled trial

Background: Chiropractic manipulation and strenuous exercise therapy have been shown effective in the treatment of nonspecific back pain. Bone-setting, the predecessor of modem manual therapies, still survives in some parts of Finland and was compared with a light exercise therapy and nonmanipulative, pragmatic physiotherapy in a year-long randomized controlled trial on patients with long-term back pain. Methods: One hundred fourteen ambulatory patients of working age with back pain for 7 weeks or more were randomly assigned to the therapies, which were offered in up to 10 sessions during a 6-week treatment period. The outcome was measured by the Oswestry Disability Questionnaire. Sick-leaves and visits to health centers were recorded for 1 year before and after the therapy. Results: The Oswestry disability scores improved most in the bone-setting cup (P = .02, Kruskall-Wallis test). Visits to health centers for back pain were reduced only in the physiotherapy group (P = .01, Wilcoxon test). Sick-leaves were not significantly different between groups. A secondary analysis based on the use of additional therapies after the intervention showed a possible subgroup with an enhanced effect from bone-setting. Conclusions: Traditional bone-setting seemed more effective than exercise or physiotherapy on back pain and disability, even 1 year after therapy.