A randomised, placebo-controlled, clinical trial for the short-term effectiveness of manipulative therapy and acupuncture on pain caused by mechanical thoracic spine dysfunction

摘要

Introduction: A randomised, assessor-blinded, placebo-controlled trial was used to compare the short-term effectiveness of manipulative therapy and acupuncture on the pain caused by mechanical thoracic spine dysfunction and on the pressure pain threshold. Subjects and Methods: The research sample consisted of 114 female patients aged 20-60 years. The primary complaint of these subjects had been pain in the thoracic spine area. After completing a questionnaire and undergoing a clinical examination, 114 subjects were diagnosed with mechanical thoracic spine dysfunction and these were randomised into the final study groups. Five persons dropped out the trial and thus the remaining 109 subjects were randomly divided into the manipulation group (n = 37), the acupuncture group (n = 35), and the placebo group (interference-electrotherapy with suction cups without electricity; n = 37). The subjects were treated four times with a 1-week follow-up assessment. The measurements of VAS and pressure pain threshold were taken on three occasions (baseline, before the second treatment and one week after the last treatment). The whole intervention took 4 weeks. Results: The VAS measurement performed one week after the last treatment indicated that manipulative therapy was superior to placebo (P-value 0.01). The intra-group results of the VAS measurements between the first and the last measurement revealed clinically significant pain reductions in all three groups. Pressure pain threshold values had increased in both the manipulation group and in the acupuncture group, whereas in the placebo group they had decreased, though the differences were not statistically significant. Conclusions: This trial suggests that manipulative therapy is more efficient than placebo in treating the pain caused by mechanical thoracic spine dysfunction when measured one week after the last treatment. In contrast, there was no significant difference between the effect of acupuncture and placebo.