The effectiveness of manual therapy, physiotherapy, and treatment by the general practitioner for nonspecific back and neck complaints. A randomized clinical trial

Spine (Phila Pa 1976). 1992 Jan;17(1):28-35. doi: 10.1097/00007632-199201000-00005.


In a randomized trial, the effectiveness of manual therapy, physiotherapy, continued treatment by the general practitioner, and placebo therapy (detuned ultrasound and detuned short-wave diathermy) were compared for patients (n = 256) with nonspecific back and neck complaints lasting for at least 6 weeks. The principle outcome measures were severity of the main complaint, global perceived effect, pain, and functional status. These are presented for 3, 6, and 12 weeks follow-up. Both physiotherapy and manual therapy decreased the severity of complaints more and had a higher global perceived effect compared to continued treatment by the general practitioner. Differences in effectiveness between physiotherapy and manual therapy could not be shown. A substantial part of the effect of manual therapy and physiotherapy appeared to be due to nonspecific (placebo) effects.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesics / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Back Pain / epidemiology
  • Back Pain / rehabilitation*
  • Diathermy
  • Female
  • Humans
  • Male
  • Manipulation, Orthopedic*
  • Massage
  • Neck*
  • Physical Therapy Modalities*
  • Placebo Effect
  • Ultrasonic Therapy


  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal