Technique Update: General Manipulation Found Effective in Lumbar Spine

Technique Update: General Manipulation Found Effective in Lumbar Spine

By Dr. David Graber, Council on Technique & Clinical Excellence Chair

A recent study in BMJ Open Sport & Exercise Medicine found that a general lumbar spinal manipulative thrust technique was as effective as a targeted manipulative thrust technique for decreasing self-reported back pain and pressure-pain thresholds.

This randomized control trial compared two groups of patients in the same side lying manipulation position setup. Each group received a single high-velocity low-amplitude thrust by a an osteopath with 13 years of manipulation experience.  One group received high velocity low amplitude SMT to the joint targeted for manipulative thrust which was the most symptomatic during the clinical examination, using active movement observation, passive movement assessment of resistance to movement and pain provocation tests. The other group received a high velocity SMT with the subject in the same position as the targeted manipulation, but the force of the thrust was not directed toward a specific lumbar level. Subjects had three repeat sessions, with a minimum of seven days and maximum of nine days between visits.

McCarthy CJ, Potter L, Oldham JA; Comparing targeted thrust manipulation with general thrust manipulation in patients with low back pain. A general approach is as effective as a specific one. A randomised controlled trial BMJ Open Sport & Exercise Medicine 2019;5:e000514. doi: 10.1136/bmjsem-2019-000514


Originally published in the ANJC Back Channel, Dec. 4, 2019

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