Back Manipulation and Mobilisation

Back manipulation is a technique commonly used for lower back pain relief.

• It is a sudden, quick movement, usually out of the control of the person receiving it.
  
  
• Often, a back manipulation is accompanied by a ‘crack’ or ‘popping’ noise. This is called cavitation and is caused by the release of a vacuum from within the joint, it’s not caused by joints being re-aligned or ‘put back in’.
  
  
• This technique is commonly performed by chiropractors, osteopaths and physiotherapists.

There is however, another very commonly used technique called joint mobilisation. Mobilisation is a technique used by physiotherapists .

Both types of techniques can be effective when used appropriately. It is likely that they:

• Encourage a reflex release in muscle spasm and therefore a reduction in pain.
  
  
• There may be a central release of endorphins, the bodies own natural pain killer.
  
  
• Finally, particularly with spinal manipulation, there is likely to be a meaningful placebo effect.

Does spinal manipulation work ?

A recent study (reference below) looked at whether spinal manipulation was effective for lower back pain relief in acute back pain.

The title of the study is a bit misleading as it actually looked at back mobilisation techniques not manipulation . The results were surprising, the treatment made no difference at all!

Bear in mind that this study was only looking at people who had back pain for a very short time. There is no evidence that it does or does not work with chronic lower back pain. If you are interested I have written a fair bit more about that study here.

References

Hancock, M., Maher, P. C., Latimer, P. J., Prof Andrew, J. M., Cooper, M. C., Prof Richard, O. D., Spindler, M., & McAuley, P. J. "Assessment of diclofenac or spinal manipulative therapy, or both, in addition to recommended first-line treatment for acute low back pain: vol. 370, p. 1638.

27-Jan-2011

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