Do you have low back pain that began recently? Are you curious about your treatment options? The first question that you may have is “what is spinal manipulation?” You may have heard people talk about it as a safe and effective way of treating back pain, which is one of the most common ailments known to man (some studies suggest that approximately 80% of humans will have at least one episode of back pain in their lifetime). Spinal manipulation is a passive technique where a physical therapist or chiropractor applies a specifically directed manual thrust to a joint, typically at or near the end of passive physiological range of motion. This is often followed by an audible ‘crack’ or ‘pop.’ The sound is caused by a cavitation within a synovial joint. When pressure is applied to the joint, the pressure rises, and a gas bubble within the joint implodes (which makes a noise). It is an intervention that physical therapists have been employing since the beginning of PT practice in the 1920s. You might wonder how a treatment like this could help your back pain. The effects of manipulation include the following: taking pressure off of sensitive body regions and tissues, increasing joint range of motion, improving blood flow, reducing muscular tension, and promoting endorphin release within the body. There are also effects that have been proposed in the literature that are of a neurophysiological nature. Recent studies have shown the neurological benefits of spinal mobilization lasting anywhere from 5 minutes to a reduction in sensitivity to pain which can last up to 24 hours. This technique is usually more beneficial for patients who have acute pain compared to more persistent pain states, but can still be an effective treatment technique in both cases. A recent high quality study, by Rajadurai and Muragan, demonstrated that spinal manipulative therapy combined with exercise is more effective than other procedures like spinal manipulation, exercise or physician consultation alone. The two most important patient identifiers to predict success of manipulation are:
- Pain lasting less than 16 days
- No radicular symptoms lower than the knee
If you fall into this category, and think spinal manipulation and exercise might be a treatment option that would benefit you, give us a call today and get scheduled for an evaluation so that we can get you back to doing what you love!
*Side Note: There are differences between PT and chiropractic manipulations, which you can read on the APTA’s website (link posted below).
Rajadurai V, Murugan K. Spinal manipulative therapy for low back pain: A systematic review. Physical Therapy Reviews. 2009;14;4;260-271.
Fritz JM, Brennan GP, Leaman H. Does the evidence for spinal manipulation translate into better outcomes in routine clinical care for patients with occupational low back pain? A case-control study. Spine J. 2006;6(3):289-295.
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