The relative effectiveness of a conservative multi-method treatment protocol (S.M.T. and Diclofenac) for the management of chronic mechanical thoracic spine pain

Abstract

The aim of this study was to determine the relative effectiveness of the combination of spinal manipulative therapy (SMT) and non-steroidal anti-inflammatory drugs (NSAIDs) versus SMT with the administration of a placebo medication in the treatment of chronic mechanical thoracic facet syndrome. It was hypothesised that SMT and NSAIDs over a three week period would be more effective than SMT and placebo medication in terms of the objective and subjective clinical findings. The study design was that of a double blind randomized clinical trial. Sixty patients diagnosed with thoracic facet syndrome were randomly assigned to either the manipulation and NSAID group or the manipulation and placebo medication group. The age range of the patients was eighteen to fifty-nine years. Each patient in the NSAID group received 139mg of diclofenac free acid per day over five days. The placebo group received the same dosage of a similar appearance to that of diclofenac free acid over the same period. The placebo medication was in the form of lactose powders. Each group of thirty patients received six treatments of SMT over a three-week period. Group A received SMT and placebo medication while Group B received SMT and NSAIDs. The patients were assessed by means of obtaining subjective information consisting of three questionnaires; the McGill Short-Form Pain Questionnaire, the Numerical Pain Rating Scale -lOl and the Oswestry Pain Disability Index. Objective data was gathered from goniometer measurements. The objective data was collected before the