Manipulation is a passive technique where the therapist applies a specifically directed manual impulse, or thrust, to a joint, at or near the end of the passive (or physiological) range of motion. The common feature of spinal manipulation techniques is the fact that they achieve a pop or cracking sound within synovial joints.
The cause of this audible release is open to some speculation but it is widely accepted to represent cavitation of a spinal facet joint.
Fritz, Cleland, and Childs published an article in 2007 entitled "Subgrouping Patients With Low Back Pain: Evolution of a Classification Approach to Physical Therapy" which lays out the Treatment Based Classification Approach and explains the classification critia for the different intervention subgroups.
is board certified in Neuromusculoskeletal medicine (NMM) and Osteopathic Manipulation (OMM). Iannetta completed his residency at the University of New England and become board certified in 2007 in NMM/OMM.
The challenge has been brought forth to many state legislators because some chiropractors have argued that manipulations are not within the scope of physiotherapy practice.
The APTA has created a page that delineates the difference between physical therapy manipulation and chiropractic manipulation.
Spinal manipulations can relieve back pain by taking pressure off sensitive nerves or tissue, increase range of motion, restoring blood flow, reducing muscle tension, and, like more active exercise, promote the release of endorphins within the body to act as natural painkillers.
Recent research has shown that the neurophysiological effects of a single session of spinal mobilization are mostly 5 minutes or less.
The best way of using the manipulations is in combination with other therapeutic modalities.An exception to these findings is hypoalgesia which may last up to 24 hours.The underlying pathological cause of low back pain (LBP) is only determined in about 15% of all cases.Spinal manipulation is a sub-group of the Treatment-Based Classification Approach for low back pain.The use of spinal manipulation as part of treatment for low back pain is recommended by several clinical practice guidelines, including the New Zealand Guidelines for Acute Low Back Pain The patients that received the most benefit from spinal manipulation for LBP are those that met at least four out of the five criteria for spinal manipulation.