Manipulative therapy is increasingly being used to treat children’s back or neck pain pain despite the lack of evidence for the effect of the treatment. It is generally recommended as a treatment option for adults, and various health professions deliver manipulative therapy either on its own or in combination with other types of therapy, e.g. advice, exercises and soft-tissue treatment.
The aim of the current study was to determine how effective manipulative therapy is when added to other treatment options on the number of recurrent episodes of back or neck pain in children aged 9 – 15 years.
In this study, researchers from the University of Southern Denmark, Spine Centre of Southern Denmark and NIKKB conclude that the addition of manipulative therapy to the treatment of schoolchildren with back or neck pain does not result in fewer recurrent episodes. However, both groups had a lower pain intensity at week 2 and the children getting manipulative therapy had a better self-reported improvement at week 2. Based on these results, the researchers cannot give any general recommendations regarding treatment, and therefore the choice of treatment for back or neck pain therefore must rely on personal preferences and other circumstances and could include conservative care with or without manipulative therapy.
The results are from a randomized controlled trial (RCT) of 238 schoolchildren aged 9 – 15 years from 13 Danish public schools from 2012 to 2014. Data was collected via text messages and clinical examinations of the participants. The participants were allocated into two groups and treatment consisted of either advice, exercises and soft-tissue treatment or advice, exercises, soft-tissue treatment plus manipulative therapy.
The primary outcome was number of recurrent episodes of back or neck pain. The secondary outcomes were duration of pain, change in pain intensity and self-reported improvement measured with the Global Perceived Effect scale.
The study was carried out by chiropractor and PhD Kristina Boe Dissing of the Department of Sports Science and Clinical Biomechanics, the University of Southern Denmark (SDU) in collaboration with Associate Professor, SDU and Senior Researcher NIKKB, Lise Hestbæk, Professor at SDU, and Senior Researcher at NIKKB; Jan Hartvigsen and Professor Niels Wedderkopp, SDU and Spine Centre Southern Denmark.
Read the full research paper here: https://bmjopen.bmj.com/content/8/9/e021358