The impact of structural therapy on functioning and pain in chronic pain patients: A pilot study

Objective: The objective of this randomized controlled trial was to assess the efficacy of correcting pelvic obliquity by heel lifts to reduce pain and improve physical and emotional functioning in patients with chronic low back pain. Methods: Subjects were >= 20 years old with low back pain for at least one year. They were randomly assigned to experimental (n = 9) or control (n = 6) groups. Degree of pelvic obliquity was determined by postural radiographs. Main outcome measures were level of pain (McGill Pain Questionnaire - Short Form), and physical and emotional functioning (Medical Outcomes Study 36-Item Short Form Health Survey) which were administered at baseline, end of treatment and 3- and 6-month follow-ups. Experimental subjects received heel lifts and custom-molded insoles to correct pelvic obliquity; controls received off-the-shelf insoles. A physical therapist taught exercises to both groups. Results: Baseline outcomes measures were similar in both groups. With treatment, experimental subjects had significant improvement in general health, physical and social functioning, and vitality, and significantly less pain than controls. Conclusion: Correction of pelvic obliquity appears to improve pain and functioning in patients with chronic low back pain.