| Terry O'Brien General Manager of Back Trouble | | | | patients. These are the patients who often |
| UK says that, "Physical therapy has a | | | | feel that something in their back has |
| significant benefit for mechanical back pain. | | | | `jammed' and feel the need for physical |
| Studies show that, for patients presenting | | | | therapy. Such patients who have received |
| with acute back pain, spinal mobilisation and | | | | relief, sometimes instantaneously, in the |
| or manipulation is more effective than | | | | past for a similar disorder will seek out |
| placebo in the short term and thus reduces | | | | therapists who provide this treatment. |
| the period of morbidity, allowing an earlier | | | | |
| return to work. | | | | Manipulation's bad name, particularly among |
| | | | surgeons who have to deal with subsequent |
| The timing of the treatment is important. If | | | | disrupted discs is related to inappropriate |
| the medical practitioner is unskilled with | | | | spinal manipulation that aggravates the |
| physical therapy, referral is appropriate. | | | | problem or fails to help over a long period |
| Spinal manipulation is contraindicated or | | | | of time. |
| ineffective in patients with acute low back | | | | |
| pain with spasm, fixed lateral scoliosis or | | | | The management of back pain is incorrectly |
| sciatica. | | | | portrayed as a difficult problem shrouded in |
| | | | medical ignorance. The physician has to |
| The gentler technique of mobilisation may be | | | | provide optimal circumstances for the |
| effective in providing relief and shortening | | | | dysfunction problem to heal itself. The key |
| the period of disability. Once the severe | | | | to successful management is for the |
| pain and spasm phase subsides (average 3-7 | | | | practitioner to be well informed, confident |
| days), then it is usually possible to apply | | | | and believable, and be prepared to give or |
| the more vigorous spinal manipulation | | | | organise safe effective physical therapy for |
| technique. However, it is possible to perform | | | | back problems which are slow to respond to |
| manipulation safely from the outset in many | | | | conservative methods. |