Manipulation Efficacy
Manual therapy is a non-surgical type of conservative management that includes different skilled hands/fingers-on techniques directed to the patient’s body (spine and extremities) for the purpose of assessing, diagnosing, and treating a variety of symptoms and conditions. Manual therapy constitutes a wide variety of different techniques which may be categorised into four major groups: a) manipulation (thrust manipulation), b) mobilisation (non-thrust manipulation), c) static stretching, and d) muscle energy techniques. The definition and purpose of manual therapy varies across health care professionals.
Spinal manipulation and mobilisation are commonly used treatment modalities for back pain, particularly by physical therapists, osteopaths, and chiropractors. Back pain is an important health problem with serious societal and economic consequences for the developed world. It is estimated that in the USA 80% of people will experience back problems at some point during their lifetime.
ESSENTIAL LITERATURE
A COMPARISON OF SPINAL MANIPULATION METHODS AND USUAL MEDICAL CARE FOR ACUTE AND SUB-ACUTELOW BACK PAIN
Schneider et. al. 2015
Conclusion:
Manual-Thrust Manipulation provides great short-term reductions in self-reported disability and pain scores compared to Mechanical-Assisted Manipulation or Usual Medical Care.
CLINICAL EFFECTIVENESS OF MANUAL THERAPY FOR MANAGEMENT OF MUSCULOSKELETAL CONDITIONS
Christine Clar et. al. 2014
Conclusion:
The evidence suggests there are similar improvements in the manipulation and/or mobilisation intervention groups compared to active treatment, however, some trials also found no improvement in comparison to a control group
DOSE-RESPONSE AND EFFICACY OF SPINAL MANIPULATION FOR CARE OF CHRONIC LOW BACK PAIN: A RANDOMIZED CONTROLLED TRIAL
Haas M et. al 2014
Conclusion:
The number of spinal manipulation visits had modest effects on cLBP outcomes above those of 18 hands-on visits to a chiropractor. Overall, 12 visits yielded the most favorable results but was not well distinguished from other dose levels.
CHIROPRACTIC AND MEDICAL TREATMENT ON THE HEALTH OF OLDER ADULTS
Weigel et.al. 2014
Conclusion:
The findings from this study suggest that chiropractic use in episodes of care for uncomplicated back conditions has protective effects against declines in ADLs, instrumental ADLs, and self-rated health for older Medicare beneficiaries over a 2-year period.
CHIROPRACTIC USE IN THE MEDICARE POPULATION: 1-YEAR CHANGES IN HEALTH AND SATISFACTION WITH CARE
Weigel et.al. 2014
Conclusion:
This study provides evidence of a protective effect of chiropractic care against 1-year declines in functional and self-rated health among Medicare beneficiaries with spine conditions, and indications that chiropractic users have higher satisfaction with follow-up care and information provided about what is wrong with them.
THE OUTCOMES OF MANIPULATION OR MOBILIZATION THERAPY COMPARED WITH PHYSICAL THERAPY OR EXERCISE FOR NECK PAINSchroeder et. al. 2013
Conclusion:
The data available suggest that there are minimal short- and long-term treatment differences in pain, disability, patient-rated treatment improvement, treatment satisfaction, health status, or functional improvement when comparing manipulation or mobilization therapy to physical therapy or exercise in patients with neck pain.
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THE RELATIVE EFFECTIVENESS OF SEGMENT SPECIFIC LEVEL AND NON-SPECIFIC LEVEL SPINAL JOINT MOBILIZATION
Slaven et. al. 2013
Conclusion:
This systematic review supports the argument that joint mobilization to the spine does lead to an immediate effect on pain at rest and pain with the most painful movement. A meta-analysis of a subset of these studies did identify that the effect of mobilization relating to a specific level or non-specific level was different based on the region of the spine being treated; the direction of effect in the cervical spine was toward specific mobilization and in the lumbar spine towards non-specific mobilization, indicating body location modified the relationship between specific versus non-specific mobilization with pain at rest.
ADDING CHIROPRACTIC MANIPULATIVE THERAPY TO STANDARD MEDICAL CARE
Goertz et. al. 2013
Conclusion:
The results of this trial suggest that CMT in conjunction with SMC offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard care, for men and women with acute LBP.
SPINAL MANIPULATION, MEDICATION, OR HOME EXERCISE WITH ADVICE FOR ACUTE AND SUBACUTE NECK PAIN: A RANDOMIZED TRIAL
Bronfort, Gert; Evans 2012
Conclusion:
For participants with acute and subacute neck pain, SMT was more effective than medication in both the short and long term. However, a few instructional sessions of HEA resulted in similar outcomes at most time points. PRIMARY FUNDING SOURCE: National Center for Complementary and Alternative Medicine, National Institutes of Health.
EVIDENCE-BASED GUIDELINES FOR THE CHIROPRACTIC TREATMENT OF ADULTS WITH HEADACHE
Bryans R et. al. 2011
Conclusion:
Evidence suggests that chiropractic care, including spinal manipulation, improves migraine and cervicogenic headaches. The type, frequency, dosage, and duration of treatment(s) should be based on guideline recommendations, clinical experience, and findings. Evidence for the use of spinal manipulation as an isolated intervention for patients with tension-type headache remains equivocal.