Complementary and alternative medical therapy combined with conventional medical care may significantly improve treatment of lower back pain

David M. Eisenberg, MD, and colleagues from Harvard Medical School and Brigham and Women's Hospital (Boston, MA), Group Health Research Institute (Seattle, WA), and Brown University (Providence, RI), compared conventional therapy alone -- defined as "usual care" -- to the combination of an integrated program of complementary and alternative medical (CAM) therapies plus usual care. They report significant differences between the two randomized patient groups in outcomes which included pain, functional status, and difficulty performing routine, self-identified challenging activities.

CAM therapies were provided by a trained team of healthcare practitioners and included acupuncture, chiropractic, massage therapy, occupational therapy, physical therapy, mind-body techniques, and nutritional counseling. Usual care consisted of treatments provided by subjects' primary care physicians and typically included non-steroidal anti-inflammatory drugs (NSAIDS), physical therapy and bed rest as needed, education, and changes in activity levels.