Low back pain: alternative practitioners feel encouraged by the recent Lancet-articles – wrongly so, I hasten to add

The media have (rightly) paid much attention to the three Lancet-articles on low back pain (LBP) which were published this week. LBP is such a common condition that its prevalence alone renders it an important subject for us all. One of the three papers covers the treatment and prevention of LBP. Specifically, it lists various […]

Read the rest here: Low back pain: alternative practitioners feel encouraged by the recent Lancet-articles – wrongly so, I hasten to add

Suffering from back pain? Walk to your therapist, don’t accept (or pay for) treatment, but walk straight back home again

We all know that there is a plethora of interventions for and specialists in low back pain (chiropractors, osteopaths, massage therapists, physiotherapists etc., etc.); and, depending whether you are an optimist or a pessimist, each of these therapies is as good or as useless as the next. Today, a widely-publicised series of articles in the […]

Read the rest here: Suffering from back pain? Walk to your therapist, don’t accept (or pay for) treatment, but walk straight back home again

The ‘Dorn Method’ – relatively new and totally bogus

Recently, I was asked about the ‘Dorn Method’. In alternative medicine, it sometimes seems that everyone who manages to write his family name correctly has inaugurated his very own therapy. It is therefore a tall order to aim at blogging about them all. But that’s been my goal all along, and after more than 1,000 […]

Read the rest here: The ‘Dorn Method’ – relatively new and totally bogus

Chiropractic is not the best treatment for back pain !!!

The question whether chiropractic is a truly valuable option for people suffering from back pain has been addressed repeatedly on this blog. My answer was usually negative, but proponents of chiropractic tended to argue that I am biased. Therefore I find it constructive to see what an organisation that hardly can be accused of bias […]

Read the rest here: Chiropractic is not the best treatment for back pain !!!

Harms of Nonpharmacologic Therapies

The new guidelines by the American College of Physicians entitled ‘Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians’ have already been the subject of the previous post. Today, I want to have a closer look at a small section of these guidelines which, I think, […]

Read the rest here: Harms of Nonpharmacologic Therapies

Acupuncture for back pain: an open letter by a Canadian therapist

Concerned about the new ACP guidelines on ‘Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians’, Andrea MacGregor asked me to publish her ‘open letter’:

I am a student about to graduate and register as a massage therapist in Canada, and I am writing to […]

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Spinal manipulation for acute low back pain, a new meta-analysis is “damning it with faint praise”

The question whether spinal manipulative therapy (SMT) is effective for acute low back pain is still discussed controversially. Chiropractors (they use SMT more regularly than other professionals) try everything to make us believe it does work, while the evidence is far less certain. Therefore, it is worth considering the best and most up-to-date data.

The aim of this […]

Read the rest here: Spinal manipulation for acute low back pain, a new meta-analysis is “damning it with faint praise”

A new systematic review of chiropractic for low back pain: far less encouraging than chiros make us believe | Edzard Ernst

Low back pain (LBP) is a ‘minor complaint’ in the sense that it does not cost patients’ lives. At the same time, LBP is amongst the leading causes of disability and one of the most common reasons for patients to seek primary care. Chiropractors, osteopaths, physical therapists and general practitioners are among those treating LBP patients, but there is only […]

Read on: A new systematic review of chiropractic for low back pain: far less encouraging than chiros make us believe

NICE no longer recommends acupuncture, chiropractic or osteopathy for low back pain | Edzard Ernst

On this blog, I have repeatedly pleaded for a change of the 2010 NICE guidelines for low back pain (LBP). My reason was that it had become quite clear that their recommendation to use spinal manipulation and acupuncture for recurrent LBP was no longer supported by sound evidence.

Two years ago, a systematic review (authored by a chiropractor and published in […]

Read on: NICE no longer recommends acupuncture, chiropractic or osteopathy for low back pain

Mind over body? Or poor science over truth? | Edzard Ernst

Mindfulness-based stress reduction (MBSR) has not been rigorously evaluated as a treatment of chronic low back pain. According to its authors, this RCT was aimed at evaluating “the effectiveness for chronic low back pain of MBSR vs cognitive behavioural therapy (CBT) or usual care.”

The investigators randomly assigned patients to receive MBSR (n = 116), CBT (n = 113), or […]
Read on: Mind over body? Or poor science over truth?

Suffering from low back pain? See a physiotherapist and not a chiropractor! | Edzard Ernst

The purpose of this study was to evaluate the impact of early and guideline adherent physical therapy for low back pain on utilization and costs within the Military Health System (MHS).

Patients presenting to a primary care setting with a new complaint of LBP from January 1, 2007 to December 31, 2009 were identified from […]

Read on: Suffering from low back pain? See a physiotherapist and not a chiropractor!

A sound study of the Alexander Technique as a treatment for neck pain. | Edzard Ernst

On this blog, we have discussed the Alexander Technique before; it is an educational method promoted for all sorts of conditions, including neck pain. The very first website I found when googling it stated the following: “Back and neck pain can be caused by poor posture.  Alexander Technique lessons help you to understand how to improve your posture throughout your daily activities.  Many people, even those with herniated disc or pinched nerve, experience relief after one lesson, often permanent relief after five or ten lessons.”

Sounds too good to be true? Is there any good evidence? […]

Read on: A sound study of the Alexander Technique as a treatment for neck pain.

Ivengar Yoga for back pain – as good or bad as most other treatments ? | Edzard Ernst

Iyengar Yoga, named after and developed by B. K. S. Iyengar, is a form of Hatha Yoga that has an emphasis on detail, precision and alignment in the performance of posture (asana) and breath control (pranayama). The development of strength, mobility and stability is gained through the asanas.

B.K.S. Iyengar has systematised over 200 classical yoga poses and 14 different types of Pranayama (with variations of many of them) ranging from the basic to advanced. This helps ensure that students progress gradually by moving from simple poses to more complex ones and develop their mind, body and spirit step by step […]

Read on: Ivengar Yoga for back pain – as good or bad as most other treatments ?

Chronic low back pain: exercise is better than chiropractic/spinal manipulation | Edzard Ernst

Chronic low back pain (CLBP) is a condition which affects so many people that it represents a huge burden to individual patients’ suffering as well as to society in terms of loss of work time and increased economic cost. The number of therapies that have been claimed to be effective for CLBP can hardly be counted. Two of the most common treatments are spinal manipulation and exercise.

The purpose of this systematic review was to determine the effectiveness of spinal manipulation vs prescribed exercise for patients diagnosed with CLBP. Only RCTs that compared head-to-head spinal manipulation to an exercise group were included in this review...

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Another bogus claim by chiropractors debunked | Edzard Ernst

How many times have we heard from practitioners of alternative medicine, particularly chiropractors, that their patients are more severely ill than those of conventional clinicians. The claim is usually that they have tried all that conventional medicine can offer and eventually, as a last resort, they turn to the alternatives.

But is this true? If so, it would explain why these patients do no better or even worse than those treated conventionally.

Here is a new article that goes some way in addressing these issues...

Read the full story: Another bogus claim by chiropractors debunked

Home-hypnotherapy for chronic low back pain – at least it is inexpensive and safe | Edzard Ernst

We all know, I think, that chronic low back pain (CLBP) is common and causes significant suffering in individuals as well as cost to society. Many treatments are on offer but, as we have seen repeatedly on this blog, not one is convincingly effective and some, like chiropractic, is associated with considerable risks.

Enthusiasts claim that hypnotherapy works well, but too little is known about the minimum dose needed to produce meaningful benefits, the roles of home practice and hypnotizability on outcome, or the maintenance of treatment benefits beyond 3 months. A new trial was aimed at addressing these issues...

Read the rest here: Home-hypnotherapy for chronic low back pain – at least it is inexpensive and safe