[Naturopathic and orthopaedic in-patient treatment of chronic back pain--a comparison study].

BACKGROUND: This study compares orthopaedic and naturopathic inpatient treatment concepts for back pain with regards to therapeutic efficacy.

PATIENTS AND METHODS: A controlled prospective cohort study is presented. 187 conservatively treated patients of an orthopaedic clinic and 161 patients of a clinic for naturopathy were recruited for the study, if they needed inpatient treatment because of chronic back pain.The results were measured with the Oswestry Score for orthopaedic symptoms as primary endpoint and the SF-36 for life quality before treatment (T0), after 3 (T2) and 6 months (T3), plus the SES for pain intensity and pain quality (T0, T1 = at discharge, T2, T3). Accompanying diseases were documented with anamnesis and catamnesis sheets. The whole collectives were evaluated. Additionally a gender specific analysis was performed.

RESULTS: For the main and secondary objectives no differences between the naturopathic and orthopaedic treatment groups (screened patients with back pain for naturopathy 286, 187 for orthopedics, in the study included patients 161 respectively 140 after 2 weeks, 62 respectively 68 after 6 months; mean age 57.1 respectively 54.0 years, female 85.1 respectively 63.6%) could be verified (Oswestry Score at T0: 43.0, 95%-confidence-interval 39.6-45.3; at T2: 40.7, 95%-confidence-interval 37.4-44.0). Only in the subgroup of women, who account for 86% of the naturopathic patients, a difference in the main objective (Oswestry Score) was found (p = 0.014) in favour of naturopathy (T2: 32.6, 95%-confidence-interval 24.9-40.2) compared to orthopedics (T2: 45.1,95%-confidence-interval 41.2-49.1).

CONCLUSION: Treatment results of naturopathic, complex" inpatient treatment of chronic back pain are comparable to conventional orthopaedic treatment at all points of time T1 to T3. The study design does not allow the conclusion, that the therapeutical concept can be changed forthetwo groups of patients with the same chance of good therapeutical efficacy. The result of the study is limited in this respect as the therapeutic effect cannot be claimed to be the same if the treatment groups were exchanged. Thus the improvement is only comparable.