Alternative Therapies for Chronic Low Back Pain

Recruiting in Palo Alto (17 mi)

Overseen byNathalie J Bureau, MD MSc

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: Centre hospitalier de l'Université de Montréal (CHUM)

No Placebo Group

Trial Summary

What is the purpose of this trial?

It is estimated that 23% of Quebecers suffer from chronic low back pain, and that 12% are disabled by this condition. Despite medical advances, the origin of so-called 'nonspecific low back pain' remains enigmatic. Conventional imaging methods by computed tomography and magnetic resonance may provide information on vertebral structures. However, very often, they do not diagnose lesions that genuinely correlate with the patient's symptoms. The lack of accurate diagnosis limits the therapeutic management in these patients. Therefore, patients are increasingly turning to alternative and complementary medicine therapies (e.g., acupuncture, chiropractic , osteopathy, shiatsu) to relieve their pain. These therapies target painful areas of abnormal hardening in muscles of the lower back and aim to release the tension in these tissues to control pain. However, these painful areas and their resolution after manual therapy have yet to be demonstrated by means other than manual palpation. We will conduct a randomized controlled trial in chronic low back pain patients to examine the effects of acupuncture, chiropractic therapy and therapeutic massage on lower back muscular and connective tissues' physical properties using innovative ultrasound techniques.

Research Team

Nathalie J Bureau, MD MSc

Principal Investigator

Centre hospitalier de l'Université de Montréal (CHUM)

Eligibility Criteria

This trial is for adults with chronic low back pain lasting at least 3 months, rating their pain at least 3/10. They should have had this issue on most days in the past half year and only used anti-inflammatory drugs recently. Participants must be willing to try acupuncture, chiropractic therapy or massage and attend follow-ups. It's not for those with specific back conditions like disc issues, infections, fractures, surgery history or who've had similar treatments in the last year.

Inclusion Criteria

I have only used oral painkillers like ibuprofen in the last 4 weeks.

I have had low back pain for at least 3 months, rating 3/10 or more.

I have experienced pain on most days in the last 6 months.

See 1 more

Exclusion Criteria

I have had a fracture in my pelvis or hip.

I have had acupuncture, spinal manipulation, or massage for back pain in the last year.

I have a severe clotting disorder or am on blood thinners.

See 3 more

Treatment Details

Interventions

Manual therapy (Procedure)

Trial OverviewThe study tests if manual therapies like acupuncture, chiropractic adjustments, and therapeutic massages can change physical properties of lower back tissues as seen by ultrasound. This randomized controlled trial aims to provide a more objective measure of these alternative treatments' effectiveness on chronic low back pain.

Participant Groups

3Treatment groups

Experimental Treatment

Group I: Waiting list and Therapeutic MassageExperimental Treatment1 Intervention

The therapeutic massage treatments will consist of one 45-minute session weekly, for 3 consecutive weeks. A technique called Fascial Release will be used. Tension related to back pain is believed to be present not only in the back but also in various parts of the body such as the legs, through the connection of fascia, the membrane that surrounds the muscles. The purpose of this treatment is to reduce the tension connected to the lower back.

Group II: ChiropracticExperimental Treatment1 Intervention

The chiropractic treatments will consist of one 20-minute session weekly, for 3 consecutive weeks. The Diversified technique is one of the most commonly practiced techniques by chiropractors. In the treatment of low back pain, this technique involves the application of a quick (high-velocity), short (low-amplitude) thrust (adjustment) to the lumbo-pelvic area.

Group III: AcupunctureExperimental Treatment1 Intervention

The acupuncture treatments will consist of one 45-minute session weekly, for 3 consecutive weeks. The acupuncture treatment protocol will be semi standardized according to usual practice. All patients will be treated with a selection of local and distant points, comprising 10 minutes of insertion time, 30 minutes of needle retention and manipulation to achieve de qi (an irradiating feeling) if possible.