Manipulation.- A therapeutic manipulation involves a low amplitude (small amount) end of range (at full stretch) thrust. It is commonly used to treat low back and mid back pain where the pain is being produced by a part of the body not moving correctly. The nudge that the manipulation gives helps the part of the body that is stiff move more freely without creating pain.
- Manipulations are not used solely on backs they can be used on other tissues that are producing pain.
- The term manipulation is also known as 'putting the back in' as if it were originally out but evidence does not suggest that any realignment takes place.
- An audible click can sometimes be heard with a manipulation.
- Following a manipulation pain free movement can be experienced. It is however generally short lived unless further corrections and management of the area of the body take place.
- Research suggests that spinal manipulation is ineffective
Recent Evidence
For Neck Pain And Whiplash,
Four systematic reviews have found that manipulation or mobilisation versus other treatments improve symptoms. One additional and one subsequent Radomised Controlled Trial (RCT) found no significant difference between mobilisation versus manipulation in pain. Rare but serious adverse effects have been reported following manipulation of the cervical spine
For Low Back Pain And Sciatica,
- Systematic reviews and additional RCTs have found that exercise versus other treatments improves pain and functional status.
- Active physiotherapy versus passive treatment all significantly reduce pain.
- Systematic reviews found conflicting evidence on the effects of spinal manipulation.
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