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