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Adjunctive diclofenac and spinal manipulation did not speed recovery of acute low back pain

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Mr M J Hancock

Correspondence to: Mr M J Hancock, University of Sydney, Sydney, New South Wales, Australia; m.hancock@usyd.edu.au

STUDY DESIGN

Design:

randomised placebo controlled trial.

Allocation:

concealed.*

Blinding:

blinded (patients, physicians, physiotherapists [to diclofenac only], outcome assessors, {data collectors, data analysts, data safety and monitoring committee}†).*

STUDY QUESTION

Setting:

general practitioner (GP) offices in Sydney, New South Wales, Australia.

Patients:

240 patients (mean age 41 y, 56% men) who had low back pain (moderate pain between 12th rib and buttock crease), with or without leg pain, causing moderate disability for <6 weeks. Exclusion criteria included episode of pain not preceded by a pain-free period of ⩾1 month, serious spinal pathology, and nerve root compromise.

Intervention:

(i) spinal manipulation (SM; 2 …

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