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Effectiveness of Spinal Manipulation by Physical Therapists

by Core Physical Therapy, June 15, 2017

Spinal Manipulation is 92% Effective for Specific Acute Low Back Pain Patients

A study performed by a group of physical therapists at Baylor University demonstrated that 63% of the sample of patients (n=70) experienced greater than 50% reduction in disability with grade V spinal manipulation coupled with range of motion exercise. Of those with favorable results, most were experiencing pain only in the low back without distal symptoms.

Several additional variables were identified as useful for predicting the outcome of spinal manipulation. Minimal fear/avoidance behavior, limited unilateral hip internal rotation, less than 16 days since onset, and the presence of spine hypomobility were typically present in those that responded well to treatment. Moreover, in a specific subgroup with 4 of 5 clinical variables present, this group had a 92% chance of 50% or better improvement in Modified Oswestry (back pain) Questionnaire scores in just one week (2 visits).

Many physical therapists are trained to perform grade V spinal manipulation and it appears that for a select subgroup of patients with acute low back pain, it is a proven treatment technique. It is also worth noting that the numbers needed to treat for this subgroup were 1.9 at 4 weeks. This is further evidence that early intervention with a physical therapist can help prevent the long-term consequences of chronic low back pain.

Evidence suggests that patients with early access to physical therapy tend to return to work sooner than when referral is delayed. In this study, having symptoms for less than 16 days was the most accurate individual variable of how quickly patients will progress.  Be sure to be seen by your physical therapist if your pain is lasting longer than a few days and interfering with you basic activities!  Spinal manipulation is a service provided by the physical therapists at Core Physical Therapy and can get you better faster!

Childs, Fritz, et al. A Clinical Prediction Rule To Identify Patients with Low Back Pain Most Likely To Benefit from Spinal Manipulation: A Validation Study. Ann Intern Med. 2004; 141:920-928.