Osteopathic Treatment of Low Back Pain

To the Editor: In comparing osteopathic spinal manipulation with standard care for patients with low back pain, Andersson et al. (Nov. 4 issue) 1 fail to recognize that many patients may have improvement with minimal or no treatment. This might have been evident had the authors included a control group of patients who received minimal or no intervention for back pain. Cherkin et al. compared the outcomes for patients with low back pain who received physical therapy, chiropractic treatment, or an educational booklet. 2 There was only a marginally better outcome in the physical-therapy and chiropractic-treatment groups than in the booklet group. . . .