• Heikki M Hemmilä, Sirkka M Keinänen-Kiukaanniemi, Sinikka Levoska, and Pekka Puska.
• Folk Medicine Centre, Kaustinen, Finland. heikki.hemmila@pp.finet.fi
• J Manipulative Physiol Ther. 2002 Feb 1; 25 (2): 99-104.

BackgroundChiropractic manipulation and strenuous exercise therapy have been shown effective in the treatment of nonspecific back pain. Bone-setting, the predecessor of modern manual therapies, still survives in some parts of Finland and was compared with a light exercise therapy and non-manipulative, pragmatic physiotherapy in a year-long randomized controlled trial on patients with long-term back pain.MethodsOne hundred fourteen ambulatory patients of working age with back pain for 7 weeks or more were randomly assigned to the therapies, which were offered in up to 10 sessions during a 6-week treatment period. The outcome was measured by the Oswestry Disability Questionnaire. Sick-leaves and visits to health centers were recorded for 1 year before and after the therapy.ResultsThe Oswestry disability scores improved most in the bone-setting group (P =.02, Kruskall-Wallis test). Visits to health centers for back pain were reduced only in the physiotherapy group (P =.01, Wilcoxon test). Sick-leaves were not significantly different between groups. A secondary analysis based on the use of additional therapies after the intervention showed a possible subgroup with an enhanced effect from bone-setting.ConclusionsTraditional bone-setting seemed more effective than exercise or physiotherapy on back pain and disability, even 1 year after therapy.

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