Journal of manipulative and physiological therapeutics
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J Manipulative Physiol Ther · Nov 1996
Randomized Controlled Trial Comparative Study Clinical TrialTrunk exercise combined with spinal manipulative or NSAID therapy for chronic low back pain: a randomized, observer-blinded clinical trial.
To study the relative efficacy of three different treatment for chronic low back pain (CLBP). Two preplanned comparisons were made: (a) Spinal manipulative therapy (SMT) combined with trunk strengthening exercises (TSE) vs. SMT combined with trunk stretching exercises, and (b) SMT combined with TSE vs. nonsteroidal anti-inflammatory drug (NSAID) therapy combined with TSE. ⋯ Each of the three therapeutic regimens was associated with similar and clinically important improvement over time that was considered superior to the expected natural history of long-standing CLBP. For the management of CLBP, trunk exercise in combination with SMT or NSAID therapy seemed to be beneficial and worthwhile. The magnitude of nonspecific therapeutic (placebo) effects, cost-effectiveness and relative risks of side effects associated with these types of therapy need to be addressed in future studies.
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J Manipulative Physiol Ther · Nov 1996
Meningovertebral ligaments and their putative significance in low back pain.
To determine the presence and morphology of the meningovertebral ligaments (ligaments of Hofmann) as well as postulate their possible contribution to low back pain. ⋯ Dural sac attachments to the posterior aspect of the vertebral bodies and the posterior longitudinal ligament could act to traction the dural sac in the event of nuclear bulge or herniation. The prevalence of these ligaments in the lumbar spine, coupled with the high incidence of herniated nucleus pulposus and disc bulges in this region, may compound the effects of disc pathology and result in increased low back pain.