Jerrilyn A. Cambron, DC, MPH, PhD’
Archives of Physical Medicine and Rehabilitation
September 2017 Volume 98, Issue 9, Pages 1752–1762
Abstract
Objectives
To investigate the efficacy of shoe orthotics with and without chiropractic treatment for chronic low back pain compared with no treatment.
Design
Randomized controlled trial.
Setting
Integrative medicine teaching clinic at a university.
Participants
Adult subjects (N=225) with symptomatic low back pain of ≥3 months were recruited from a volunteer sample.
Interventions
Subjects were randomized into 1 of 3 treatment groups (shoe orthotic, plus, and waitlist groups). The shoe orthotic group received custom-made shoe orthotics. The plus group received custom-made orthotics plus chiropractic manipulation, hot or cold packs, and manual soft tissue massage. The waitlist group received no care.
Main Outcome Measures
The primary outcome measures were change in perceived back pain (numerical pain rating scale) and functional health status (Oswestry Disability Index) after 6 weeks of study participation. Outcomes were also assessed after 12 weeks and then after an additional 3, 6, and 12 months.
Results
After 6 weeks, all 3 groups demonstrated significant within-group improvement in average back pain, but only the shoe orthotic and plus groups had significant within-group improvement in function. When compared with the waitlist group, the shoe orthotic group demonstrated significantly greater improvements in pain (P<.0001) and function (P=.0068). The addition of chiropractic to orthotics treatment demonstrated significantly greater improvements in function (P=.0278) when compared with orthotics alone, but no significant difference in pain (P=.3431). Group differences at 12 weeks and later were not significant.
Conclusions
Six weeks of prescription shoe orthotics significantly improved back pain and dysfunction compared with no treatment. The addition of chiropractic care led to higher improvements in function.