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Spinal Manipulation in the Treatment of Low-Back Pain. Can. Fam. Physician Vol. 31: March 1985

Kirkaldy-Willis et al. Spinal Manipulation in the Treatment of Low-Back Pain. Can. Fam. Physician Vol. 31: March 1985

Summary: Spinal manipulation, one of the oldest forms of therapy for back pain, has mostly been practiced outside of the medical profession. Over the past decade, there has been an escalation of clinical and basic science research on manipulative therapy, which has shown that there is a scientific basis for the treatment of back pain by manipulation.

Most family practitioners have neither the time nor inclination to master the art of manipulation and will wish to refer their patients to a skilled practitioner of this therapy. Results of spinal manipulation in 283 patients with low back pain are presented. The physician who makes use of this resource will provide relief for many patients.

Points of Interest:
*80% of the adult population will experience LBP during their adult life.

*At any given time 20-30% of adults suffer from LBP.

*In industry, disorders of the LB account for 4 hours/yr/worker of lost time.

*LBP is second only to upper respiratory infections as cause for absenteeism.

*Patients with LBP represent a major segment of the chronically disabled.

*Estimates for the cost of tx and compensation in US exceed $14 billion annually.

*Less than 10% of LBP is due to herniation or the IVD or entrapment of spinal nerves. Most LBP is mechanical in nature.

*Spinal manipulation is essentially an assisted passive motion applied to the spinal apophyseal and sacroiliac joints.

*Three ranges of motion exist in the spine: active motion, passive motion, and paraphysiological motion.

*Only manipulation spans all three ranges of motion.

*Since 1952 there have been over 50 clinical trials of spinal manipulation for back pain.