OBJECTIVES: The aim of this trial was to establish the effectiveness of traditional bone setting (TBS) compared with conventional physical and exercise therapy (PhT) in treating chronic low back pain (cLBP). DESIGN: Randomised clinical trial. SETTING: Working-aged cLBP patients (n = 131, age range 29 to 51 years) were randomised into two treatment groups: TBS and PhT. Follow-up assessments took place 1, 6 and 12 months after treatment. INTERVENTIONS: TBS is a popular traditional manual mobilisation therapy for musculoskeletal disorders in Finland. Conventional PhT was used as the reference treatment. MAIN OUTCOME MEASURES: LBP intensity (visual analog scale 0 to 100, VAS), the Oswestry Disability Index (ODI), the global assessment score (scale -1 to +10), a health-related quality of life (HRQoL) assessment and spine mobility measurements were used as measures. RESULTS: 118 patients (95.9%, 59 men and 59 women) completed the treatment program. Both treatments reduced the VAS and ODI levels after 1 month. Changes in VAS did not differ between the two treatment groups (mean -0.2, CI -11.3 to 10.9). The improvement in ODI (mean 2.4, CI -1.2 to 6.0, p = 0.069, repeated measurements ANOVA) and quality of life scores (mean -0.03, CI -0.06 to 0, p = 0.056) tended to be greater after TBS. Additionally, global assessment scores were better for TBS-treated patients (Mann-Whitney test, p = 0.001). There were no differences between the spine mobility test results of the two groups. Changes in both VAS (mean -2.4, CI -15.5 to 10.6) and ODI (mean 1.0, CI -3.0 to 5.1) measures did not, however, differ between the groups at the 1-year follow-up stage. CONCLUSIONS: Most cLBP patients found the treatments to be beneficial. Although the long-term dynamics of pain and disability did not differ between the groups, the subjective benefits appeared to be more significant after TBS.

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