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Exercise therapy is highly effective for treating chronic low-back pain - but that doesn't necessarily mean there isn't an even better treatment out there. A recent study in the scientific journal Spine provides further evidence of the power of spinal manipulation for back pain.

In the study, approximately 50 patients with chronic low-back pain who had been sick-listed for between eight weeks and six months received either exercise therapy or manual therapy. The patients, ages 20-60, were administered sixteen 45-minute treatments over eight weeks; patient improvement was measured before and after treatment and at four weeks, six months and one year after treatment.

Patients in the manual-therapy group received mobilization and high-velocity, low-amplitude manipulation from trained physiotherapists (a form of treatment chiropractors also utilize) and performed general exercises for the trunk, spine and legs. Exercise-group patients trained with a 35-minute focus on the trunk and legs following 10 minutes of warm-up on an exercise bicycle.

Both groups showed significant improvements; however, the manual-therapy group experienced much greater improvements than the exercise group in all areas of improvement (pain, functional status, etc.) at every point in follow-up. For example, average reduction in pain was doubled for manual-therapy patients, compared to exercise patients. Also, immediately following the treatment period, the manual-therapy group was significantly more likely to have returned to work (67%, vs. 27% for the exercise group). One year later, exercise-therapy patients were over three times more likely to still be sick-listed than manual-therapy patients.

If you suffer from low-back pain, spinal manipulation may be the best form of treatment. Talk to your local chiropractor about the benefits of spinal adjustments. For more information on back pain, visit

Reference: Aure OF, Nilsen JH, Vasseljen O. Manual therapy and exercise therapy in patients with chronic low back pain: A randomized, controlled trial with 1-year follow-up. Spine 2003:28(6), pp. 525-532.


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