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KMID : 0948920030020020155
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Clinical Pain
2003 Volume.2 No. 2 p.155 ~ p.161
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Manipulative Treatment of Low Back Pain
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Lee Seung-Won
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Abstract
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Manipulative treatment is a therapeutic methodology encompassing multiple therapeutic disciplines such as of chiropractics, osteopathy, orthopedic medicine, manual medicine, and applied kinesiology. Although the therapeutic effects of such types of treatment on the body may be similar, the historical background and theories of effectiveness of manipulation are different for each individual discipline. Manipulations of most disciplines are classically performed with the hands. The techniques of Activator, Pettibone, Cox and Leander employ specialized equipment and treatment tables. Manipulative treatment of low back pain can be divided into two categories; direct manipulation to the low back area and manipulation in areas that can indirectly affect to low back, such as the cervical spine, temporomandibular joint (TMJ), cranium, rib and low extremity. Back muscles are mainly under the control of reflexogenic shunt stability of the cerebellum, while spine and pelvis motion segments can also send afferent information up to the cerebellum. Cranio-sacral motion is referred to the craniosacral primary respiratory movement which implies that problems in cranial motion may affect sacral movement. Adequate understanding of the neurophysiological concepts and cranio-pelvic relationship will increase the success rate of low back pain treatment with manipulation therapy.
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KEYWORD
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Low back pain, Treatment, Manipulation
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