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Medication-assisted spinal manipulation.

Frank J Kohlbeck1, Scott Haldeman

  • 1Health Services Department, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.

The Spine Journal : Official Journal of the North American Spine Society
|November 1, 2003
PubMed
Summary

Medication-assisted spinal manipulation therapy, combining manual therapy with medications or injections, has a long history but limited evidence. Further controlled trials are needed to validate its effectiveness for chronic pain.

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Area of Science:

  • Orthopedics and Sports Medicine
  • Pain Management
  • Physical Therapy

Background:

  • Spinal manipulation is increasingly used with medications and injections for spinal pain.
  • Manual therapy is often combined with anesthetics, sedatives, analgesics, and various injection types.

Purpose of the Study:

  • To review literature on medication-assisted spinal manipulation therapy (MASMT).
  • To describe current clinical practices, indications, contraindications, and complications of MASMT.

Main Methods:

  • Literature review using PubMed (1966-present).
  • Integration of information from personal interviews, courses, and clinical observations.
  • Searched for articles combining spinal manipulation with anesthesia, sedation, and injections.

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Main Results:

  • Four categories of MASMT identified: under general anesthesia/sedation, epidural anesthesia, joint anesthesia/analgesia, and with injectants.
  • Literature predominantly comprises case reports and series; only two randomized controlled trials and one cohort study found.

Conclusions:

  • MASMT has a long history but evidence for effectiveness is largely anecdotal.
  • Case series suggest potential benefits, warranting further controlled trials.
  • Theoretical basis and positive case series results support continued investigation.