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Can Fam Physician. 1985 March; 31: 535–540.
PMCID: PMC2327983

Spinal Manipulation in the Treatment of Low-Back Pain


Spinal manipulation, one of the oldest forms of therapy for back pain, has mostly been practiced outside of the medical profession. Over the past decade, there has been an escalation of clinical and basic science research on manipulative therapy, which has shown that there is a scientific basis for the treatment of back pain by manipulation. Most family practitioners have neither the time nor inclination to master the art of manipulation and will wish to refer their patients to a skilled practitioner of this therapy. Results of spinal manipulation in 283 patients with low back pain are presented. The physician who makes use of this resource will provide relief for many patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Frymoyer JW, Newberg A, Pope MH, Wilder DG, Clements J, MacPherson B. Spine radiographs in patients with low-back pain. An epidemiological study in men. J Bone Joint Surg Am. 1984 Sep;66(7):1048–1055. [PubMed]
  • Foley RK, Kirkaldy-Willis WH. Chronic venous hypertension in the tail of the Wistar rat. Spine (Phila Pa 1976) 1979 May-Jun;4(3):251–257. [PubMed]
  • Farfan HF, Kirkaldy-Willis WH. The present status of spinal fusion in the treatment of lumbar intervertebral joint disorders. Clin Orthop Relat Res. 1981 Jul-Aug;(158):198–214. [PubMed]
  • Currey HL, Greenwood RM, Lloyd GG, Murray RS. A prospective study of low back pain. Rheumatol Rehabil. 1979 May;18(2):94–104. [PubMed]
  • Unsworth A, Dowson D, Wright V. 'Cracking joints'. A bioengineering study of cavitation in the metacarpophalangeal joint. Ann Rheum Dis. 1971 Jul;30(4):348–358. [PMC free article] [PubMed]
  • Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965 Nov 19;150(3699):971–979. [PubMed]
  • Terrett AC, Vernon H. Manipulation and pain tolerance. A controlled study of the effect of spinal manipulation on paraspinal cutaneous pain tolerance levels. Am J Phys Med. 1984 Oct;63(5):217–225. [PubMed]
  • Korr IM. Proprioceptors and somatic dysfunction. J Am Osteopath Assoc. 1975 Mar;74(7):638–650. [PubMed]
  • Akeson WH, Amiel D, Woo SL. Immobility effects on synovial joints the pathomechanics of joint contracture. Biorheology. 1980;17(1-2):95–110. [PubMed]
  • Mathews JA, Ytes DA. Reduction of lumbar disc prolapse by manipulation. Br Med J. 1969 Sep 20;3(5672):696–697. [PMC free article] [PubMed]
  • Nwuga VC. Relative therapeutic efficacy of vertebral manipulation and conventional treatment in back pain management. Am J Phys Med. 1982 Dec;61(6):273–278. [PubMed]
  • Morrison MC. The best back to manipulate? Ann R Coll Surg Engl. 1984 Jan;66(1):52–53. [PMC free article] [PubMed]
  • Brunarski DJ. Clinical trials of spinal manipulation: a critical appraisal and review of the literature. J Manipulative Physiol Ther. 1984 Dec;7(4):243–249. [PubMed]
  • Evans DP, Burke MS, Lloyd KN, Roberts EE, Roberts GM. Lumbar spinal manipulation on trial. Part I--clinical assessment. Rheumatol Rehabil. 1978 Feb;17(1):46–53. [PubMed]
  • Coxhead CE, Inskip H, Meade TW, North WR, Troup JD. Multicentre trial of physiotherapy in the management of sciatic symptoms. Lancet. 1981 May 16;1(8229):1065–1068. [PubMed]
  • Weber H. Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine (Phila Pa 1976) 1983 Mar;8(2):131–140. [PubMed]
  • Jayson MI, Sims-Williams H, Young S, Baddeley H, Collins E. Mobilization and manipulation for low-back pain. Spine (Phila Pa 1976) 1981 Jul-Aug;6(4):409–416. [PubMed]
  • Roberts GM, Roberts EE, Lloyd KN, Burke MS, Evans DP. Lumbar spinal manipulation on trial. Part II--radiological assessment. Rheumatol Rehabil. 1978 Feb;17(1):54–59. [PubMed]
  • Doran DM, Newell DJ. Manipulation in treatment of low back pain: a multicentre study. Br Med J. 1975 Apr 26;2(5964):161–164. [PMC free article] [PubMed]
  • Kirkaldy-Willis WH, Farfan HF. Instability of the lumbar spine. Clin Orthop Relat Res. 1982 May;(165):110–123. [PubMed]

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