Difficult to assess role of manipulation in back pain
In sports medicine, we are living in an age where the expectation for injury management is that treatments should be evaluated by randomised control trials (RCTs) yet the reality is that the vast majority of our treatments have not been assessed. Many of the treatments we use are probably effective and many probably aren't, but it may be years before we can tell which is which. In the meantime, clinicians don't have much choice but to rely on their experience in recommending the best treatments. An article in the SMH discusses how it is difficult to even design an RCT to assess the effectiveness of manipulation in low back pain. Click to read the full article. And even if and when an RCT shows a treatment to be effective, there is still the possibility of scientific fraud from the authors, which is being detected more frequently. Click to read an editorial and a debate article from the MJA on scientific fraud. Read also from this website the role of EBM in assessing which is the best ACL reconstruction and whether the trials tell us enough. Also from this website, an article on the relationship between lumbar spine pathology and hamstring and calf injuries. An interesting theory but how do you test it with EBM? |
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