Treatments for Back Pain
Authors: John D. Childs, Julie M. Fritz, Timothy W. Flynn
Journal: Annals of Internal Medicine (2005)

Letters17 May 2005Treatments for Back PainJohn D. Childs, PT, PhD, Julie M. Fritz, PhD, PT, and Timothy W. Flynn, PhD, PTJohn D. Childs, PT, PhDFrom Wilford Hall Medical Center, Schertz, TX 78154; University of Utah, Salt Lake City, UT 84108; and Regis University, Denver, CO 80221-1099.Search for more papers by this author, Julie M. Fritz, PhD, PTFrom Wilford Hall Medical Center, Schertz, TX 78154; University of Utah, Salt Lake City, UT 84108; and Regis University, Denver, CO 80221-1099.Search for more papers by this author, and Timothy W. Flynn, PhD, PTFrom Wilford Hall Medical Center, Schertz, TX 78154; University of Utah, Salt Lake City, UT 84108; and Regis University, Denver, CO 80221-1099.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-10-200505170-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dr. Deyo raises several interesting considerations regarding the interpretation of our results (1) in his editorial (2). Numerous previous studies, particularly those examining the outcomes of spinal manipulation, have resulted in relatively small effect sizes of modest clinical importance (3). Had we simply compared the outcomes of manipulation versus an exercise intervention, our results would have favored manipulation by a statistically significant but clinically trivial amount. However, the treatment effects were about 70% greater in the subgroup of patients who fit the rule for predicting a favorable response to manipulation, supporting the notion that the solution to ...References1. Childs JD, Fritz JM, Flynn TW, Irrgang JJ, Johnson KK, Majkowski GR, et al. A clinical prediction rule to identify patients with low back pain most likely to benefit from spinal manipulation: a validation study. Ann Intern Med. 2004;141:920-8. [PMID: 15611489] LinkGoogle Scholar2. Deyo RA. Treatments for back pain: can we get past trivial effects? [Editorial]. Ann Intern Med. 2004;141:957-8. [PMID: 15611493] LinkGoogle Scholar3. Assendelft WJ, Morton SC, Yu EI, Suttorp MJ, Shekelle PG. Spinal manipulative therapy for low back pain. A meta-analysis of effectiveness relative to other therapies. Ann Intern Med. 2003;138:871-81. [PMID: 12779297] LinkGoogle Scholar4. Hides JA, Jull GA, Richardson CA. Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine. 2001;26:243-8. [PMID: 11389408] CrossrefMedlineGoogle Scholar5. O'Sullivan PB, Phyty GD, Twomey LT, Allison GT. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine. 1997;22:2959-67. [PMID: 9431633] CrossrefMedlineGoogle Scholar6. United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care. BMJ. 2004;329:1377. [PMID: 15556955] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Wilford Hall Medical Center, Schertz, TX 78154; University of Utah, Salt Lake City, UT 84108; and Regis University, Denver, CO 80221-1099.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSpinal Manipulative Therapy for Low Back Pain Willem J.J. Assendelft , Sally C. Morton , Emily I. Yu , Marika J. Suttorp , and Paul G. Shekelle Treatments for Back Pain: Can We Get Past Trivial Effects? Richard A. Deyo A Clinical Prediction Rule To Identify Patients with Low Back Pain Most Likely To Benefit from Spinal Manipulation: A Validation Study Maj John D. Childs , Julie M. Fritz , Timothy W. Flynn , James J. Irrgang , Maj Kevin K. Johnson , Maj Guy R. Majkowski , and Anthony Delitto Metrics Cited ByEffects of low back pain stabilization or movement system impairment treatments on voluntary postural adjustments: a randomized controlled trialClinical Prediction Rules, Part 1: Conceptual OverviewYou are as you smell: the effect of odor and breath odor on social acceptance 17 May 2005Volume 142, Issue 10Page: 874KeywordsClinical trialsConflicts of interestExerciseHealth careLower back painMotivationPatientsResearch funding ePublished: 17 May 2005 Issue Published: 17 May 2005 CopyrightCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...