Abordagens de gerenciamento e as diferenças entre a manipulação vertebral direcionada e a manipulação vertebral genérica em indivíduos com dor lombar crônica

Abstract

Background: Low back pain is extremely common and is associated with disability. It is critical that clinicians and policy makers follow the best evidence using high-value care for patients with low back pain. Therefore, non-evidence-based procedures should be abandoned immediately. Evidence-based procedures have the potential to reduce social costs and improve the quality of life for these patients. Objective: To investigate whether there is a difference between manipulating a painful vertebral segment and manipulating a vertebral segment distant from the painful segment in patients with chronic low back pain. Methods: 148 patients with chronic low back pain do not specify at least three points of pain intensity (measured from 0-10 by the Numerical Verbal Pain Scale). Interventions: All patients received 10 sessions of spinal manipulation over a period of four weeks. The specific manipulation group received the manipulation sessions in the most painful segment of the lumbar spine. The non-specific manipulation group, on the other hand, received manipulation sessions in the medium / high thoracic spine. Outcomes: The primary outcome was pain intensity, measured 4 weeks after randomization. Secondary outcomes were pain intensity at 3 and 6 months after randomization, blood pressure threshold at 4 weeks after randomization, and the perception of the overall effect and disability at 4 weeks, 3 and 6 months after randomization. Results: There were no clinically important differences between groups for pain intensity, disability and perception of the overall effect, at all time points. Conclusion: No differences were observed between specific manipulations and non-specific manipulations in patients with chronic low back pain.