A controlled, multicentre trial of manual therapy with steroid injections in low-back pain: functional variables, side effects and complications during four months follow-up

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Abstract
Outpatients with acute or subacute low-back pain were randomly allocated to one of two treatment groups. One group (n = 53) was given standardized but optimized conventional activating treatment by primary health care teams. The other group (n = 48) received specific manual treatment such as manipulation, specific mobilization, muscle stretching, autotraction and cortisone injections. There were significant differences on 15 disability rating scores and complaints in everyday life due to low-back problems in favour of the group receiving manual treatment, indicating that this treatment was superior to conventional treatment. The patients given manual treatment had a more positive view of treatment than those in the conventionally treated group. The experimental treatment was more painful than the conventional treatment, due to injections and muscle stretching. Only a few patients experienced manipulation and specific mobilization as painful. No persisting deterioration or complications were reported due to the experimental treatment.