PUBLISHED STUDIES
Study 1
Comparison of 2 Multimodal Interventions With and Without Whole Body Vibration Therapy Plus Traction on Pain and Disability in Patients With Nonspecific Chronic Low Back Pain.
Maddalozzo GF, , Kuo, B, Maddalozzo WA, Maddalozzo CD, Galver, JW. (2016).
Chronic low back pain (CLBP) is a persistent issue that many people face, often caused by multiple factors, making both diagnosis and treatment challenging. This study aims to evaluate the effectiveness of two exercise-based physical therapy approaches in reducing pain for CLBP patients.
Study Overview
The research analyzed data from two groups of patients with non-specific chronic low back pain (lasting more than three months) and significant pain levels (scoring 7 or higher on a Numeric Rating Scale). The two groups were:
Focus On Therapeutic Outcomes (FOTO): 55 participants, average age 55.
Illinois Back Institute (IBI): 70 participants, average age 48.
Both groups followed similar physical therapy programs, including stretching, core stability, posture correction, and strengthening exercises. However, the IBI group also received additional treatments like decompression therapy and exercises targeting altered movement patterns.
Focus On Therapeutic Outcomes (FOTO): 55 participants, average age 55.
Illinois Back Institute (IBI): 70 participants, average age 48.
Both groups followed similar physical therapy programs, including stretching, core stability, posture correction, and strengthening exercises. However, the IBI group also received additional treatments like decompression therapy and exercises targeting altered movement patterns.
Results
Pain and disability levels were measured at the start of the therapy and upon discharge using the Oswestry Disability Index (ODI) and the Numeric Rating Scale (NRS).
Numeric Rating Scale
Oswestry Disability Index (ODI)
Conclusion
The combination of exercise, decompression, and traction used in the IBI group was significantly more effective in reducing pain and improving function compared to exercise alone. This approach may offer a non-surgical alternative for managing chronic low back pain and minimizing the need for medication.
Comprehensive Analysis of Chronic Low Back Pain Treatments
This study provides an in-depth look at the effectiveness of two multimodal treatments for patients with nonspecific chronic low back pain (CLBP), focusing on both pain relief and improved physical function. The analysis includes starting and ending scores from two key metrics: the Oswestry Disability Index (ODI), which measures functional disability, and the Numeric Rating Scale (NRS), which tracks pain levels.
Key Findings:
- ODI Improvements: The study tracked patients’ ability to perform daily activities before and after treatment, with significant reductions in disability scores.
- NRS Pain Reduction: Participants reported substantial decreases in pain intensity after completing the treatment protocols.
- Conditions Treated: The study also details the various conditions affecting the participants, such as herniated discs, degenerative disc disease, and sciatica, offering insight into how these treatments performed across different patient profiles.
- Patient Demographics: Data on the number of patients in each group, their age range, and other relevant demographic factors are included to provide a comprehensive understanding of the patient population.
This study helps to showcase the measurable benefits of these therapies, particularly in how they improve patients’ overall quality of life by reducing pain and disability.
Conclusion
The combination of exercise, decompression, and traction used in the IBI group was significantly more effective in reducing pain and improving function compared to exercise alone. This approach may offer a non-surgical alternative for managing chronic low back pain and minimizing the need for medication.
Our patients' symptoms, Previous therapy and Medications Prior to Treatment
This section of the study explores the patient demographics and pre-existing conditions among individuals suffering from chronic low back pain (CLBP), many of whom had previously undergone multiple treatments without lasting relief. The findings highlight the challenges faced by this patient population and the severity of their conditions.
Patient Background:
- Two distinct patient groups were analyzed:
- Focus on Therapeutic Outcomes, Inc. (FOTO): 55 patients, average age 55.
- Illinois Back Institute (IBI): 70 patients, average age 48.
- Medication Use:
- 44% of patients were taking opioid medications to manage their pain.
- 97% were using over-the-counter NSAIDs.
- Medical Imaging Results (MRI):
- 74% had bulging discs.
- 97% had degenerative disc disease.
- 79% had herniated discs.
- 100% were diagnosed with sciatica, based on a positive contralateral straight leg raise test.
- Additional diagnoses included spondylolisthesis (20%) and spinal stenosis (66%).
Previous Treatments:
Before joining the IBI program:
- 80% of patients had tried physical therapy.
- 64% had undergone spinal manipulation (chiropractic care).
- 40% received epidural steroid injections or selective nerve root blocks.
This detailed analysis underscores the complex nature of CLBP in these patients, many of whom had tried multiple treatment avenues prior to enrolling in the IBI therapeutic program. It paints a clear picture of the severity and persistence of their conditions, making the case for innovative treatment approaches to provide relief where traditional methods may have fallen short.
Prevalence of Conditions, Previous Treatments, and Medication Use Among Patients displayed as % of total participants
Click below to download the full report and explore the data behind these findings.
Study 2
A Novel Treatment Combination for Failed Back Surgery Syndrome, With a 41-Month Follow-Up: A Retrospective Case Report
The purpose of this retrospective case report was to describe chiropractic management of a patient with failed back surgery syndrome.
Clinical Features
A 45-year-old woman presented 2 years after L4-L5 and L5-S1 fusion surgery with low back and sciatic pain. Her physical exam included a positive straight leg raise and diminished lower-extremity reflexes and muscle strength. The patient’s magnetic resonance imaging showed right disc bulging and annular tearing at L2-L3 and L3-L4 disc bulging with foraminal impingement.
Intervention and Outcome
A total of 52 treatments were provided over 28 weeks consisting of multidirectional functional decompression (FD) unweighted gait training, core exercises while in FD, strengthening exercises on a vibration platform, and supine spinal FD with vibration and chiropractic spinal manipulative therapy. Over the course of treatment, the patient noted gradual improvement in function (Oswestry Disability Index) and pain (Numeric Rating Scale), with a reduction in pain medications. Follow-up of 41 months posttreatment revealed an Oswestry Disability Index score of 0 and Numeric Rating Scale score of 0, and the patient no longer was using any pain medication.
| Characteristic | Intake | Week 4 | Week 8 | Week 12 | Week 16 | Week 20 | Week 24 | Week 28 | 41-Month Follow-up Posttreatment |
|---|---|---|---|---|---|---|---|---|---|
| ODI raw score | 25 | 22 | 21 | 19 | 15 | 22 | 6 | 4 | 0 |
| ODI percentage | 50 | 44 | 42 | 38 | 30 | 22 | 12 | 8 | 0 |
| ODI change in points from baseline | 0 | 3 | 4 | 6 | 10 | 14 | 19 | 21 | 25 |
| ODI decrease % change in score from intake | 0 | 6 | 8 | 12 | 20 | 28 | 38 | 42 | 50 |
| NRS | 8 | 8 | 7 | 6 | 5 | 3 | 2 | 1 | 0 |
| Hydrocodone-acetaminophen 10/325 | 6/d | 0 | 0 | 6/d | 6/d | 4/d | 4/d | 2/d | No medication |
| Fentanyl 50 mcg/hr Transd Patch | 1/d | 1/d | 1/d | 0 | 0 | 0 | 0 | 0 | No medication |
| Pregabalin (300 mg/d) | 1/d | 1/d | 1/d | 1/d | 1/d | 1/d | 1/d | 1/d | No medication |
| Sertraline (50 mg) | 1/d | 1/d | 1/d | 1/d | 1/d | 1/d | 1/d | 1/d | No medication |
Conclusion
After a course of care, the patient in this study reported resolution of symptoms, decrease in pain medications, and improvement of function.
OR WATCH