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Efficacy of manual therapy.
1Department of Rehabilitation Medicine, University of Minnesota, Minneapolis 55455.
Physical Therapy
|December 1, 1992
Summary
Manual therapy, especially spinal manipulation, effectively treats low back pain. Patients with acute onset, short symptom duration, and specific pain patterns are most likely to benefit from this treatment.
Area of Science:
- Orthopedics
- Physical Medicine
- Rehabilitation
Background:
- Manual therapy is widely used for somatic pain syndromes.
- Previous research on manual therapy efficacy yielded equivocal findings, preventing definitive conclusions.
Purpose of the Study:
- Establish objective criteria for evaluating manual therapy research validity.
- Identify and discuss valid research on manual therapy efficacy or lack thereof.
- Determine common characteristics of patients who benefit from manual therapy.
Main Methods:
- Reviewed 146 titles, eliminating 105 non-primary studies.
- Assessed 41 remaining studies for statistical comparisons and blinded outcome measures.
- Categorized 14 valid efficacy studies by anatomical region, research goals, and intervention type.
Main Results:
- Manual therapy, particularly manipulation, is effective for low back pain.
- A patient profile for beneficial manual therapy includes acute onset (<1 month), central/paravertebral pain, no prior manipulation, and no pending litigation/workers' compensation.
- Paucity of valid explanatory research exists for peripheral joints, but low back pain has extensive study.
Conclusions:
- Manual therapy, especially manipulation, provides clear evidence of efficacy for low back pain.
- Objective criteria were established for judging manual therapy research validity.
- A preliminary patient profile aids in identifying individuals likely to benefit from manual therapy for low back pain.