One-year follow-up of a randomized clinical trial comparing flexion distraction with an exercise program for chronic low-back pain

J Altern Complement Med. 2006 Sep;12(7):659-68. doi: 10.1089/acm.2006.12.659.


Objective: Flexion distraction is a commonly used form of chiropractic care with chiropractor utilization rates of 58%. However, no previous randomized clinical trial has assessed the effectiveness of this form of care. The objective of this investigation was to compare the pain and disability during the year after active care based on treatment group allocation (Flexion Distraction versus Exercise Program).

Study design: Randomized clinical trial, follow-up.

Subjects: Two hundred and thirty-five (235) subjects who were previously randomized to either chiropractic care (flexion distraction) or physical therapy (exercise program) within a clinical trial.

Outcome measures: Subjects were followed for 1 year via mailed questionnaires to assess levels of pain (Visual Analog Scale) and dysfunction (Roland Morris).

Results: Study subjects had a decrease in pain and disability after intervention regardless of which group they attended (p < 0.002), however, during the year after care, subjects who received chiropractic care (flexion distraction therapy) had significantly lower pain scores than subjects who received physical therapy (exercise program) (p = 0.02).

Conclusions: In this first trial on flexion distraction care, flexion distraction was found to be more effective in reducing pain for 1 year when compared to a form of physical therapy.

Publication types

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

MeSH terms

  • Adult
  • Exercise Therapy / methods*
  • Exercise Therapy / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Humans
  • Low Back Pain / epidemiology
  • Low Back Pain / therapy*
  • Male
  • Manipulation, Chiropractic / methods*
  • Manipulation, Chiropractic / statistics & numerical data
  • Middle Aged
  • Pain Measurement / methods
  • Patient Satisfaction / statistics & numerical data*
  • Quality of Life*
  • Range of Motion, Articular
  • Research Design
  • Surveys and Questionnaires
  • Treatment Outcome