The Research Status Of Spinal Manipulative Therapy

At the request of a Subcommittee of the United States Senate, in February, 1975, the National Institute of Neurological Disorders and Stroke (now the National Institute of Neurological and Communi cative Disorders and Stroke) conducted a Workshop on the Research Status of Spinal Manipulative Therapy. The Workshop was held in response to the Senate Subcommittee's request for an "independent unbiased study of the fundamentals of the chiropractic profession. " Since spinal manipulative therapy is a key tenet of chiropractic, the Institute felt a research workshop focused on that issue would provide a useful base upon which to examine the broad concept of the role of biomechanical alterations of the spine in health and disease. This would include the pathophysiologic and clinical hypotheses formulated by medical and osteopathic physicians as w~ll as chiropractors. Why the relatively sudden interest of the Senate Subcommittee in chiropractic? There were probably many reasons for that interest, but suffice to say anticipation of discussion on the role of chiro practic in any national system of health insurance could in itself have provided adequate stimulus for the request. In any case, the NINCDS was asked to review what was and what was not known about the fundamentals of chiropractic. I stress "fundamentals" since as a research organization, the NINCDS is not charged with review ing matters such as clinical education, licensure or clinical prac tice. A small expert committee of scientific consultants helped the Institute design the format and agenda for the Workshop.

The first book ever to bring together the best techniques from chiropractic and osteopathy, this easy-to-use guide is necessary reading for any manual therapist wishing to hone their skills, and discover related techniques that will enhance their practice. Offering practical step-by-step instruction on how to treat a full scope of musculoskeletal conditions, this duo-disciplinary guide draws on current anatomical and physiological research to bring all the most advanced and adaptive manipulation therapy techniques to your fingertips. Providing a brief history of the two central branches of manual therapy, it gives a valuable insight into how manipulation therapists can benefit from sharing ideas and integrating versatile techniques across practices, before providing clear, illustrated references for how to apply the methods on specific sections of the body. Demonstrating how to relieve common ailments, recognise contraindications and take excellent safety precautions, this is the ideal companion for practitioners and students of manipulation therapy for the whole body.

Manipulative Therapy provides a systematic overview of chain reactions which are the basis of a rational holistic approach. These reactions are closely related to the upright human posture and to the "deep stabilisation system" as shown in the work of Richardson et al in Therapeutic Exercise for Spinal Stabilisation in Low Back Pain. This approach has meant a considerable advance in the therapy and rehabilitation of patients. It gives a balanced picture of the importance of musles, joints and soft tissues, under the control of the nervous system, the textbook aims to treat disturbance of function, the most common cause of pain in the motor system, in the most effective way. Locomotor system dysfunctions are shown to be treated very effectively using manual medicine techniques. Spinal column and joint mobility can be restored, and pain triggered by the autonomic nervous system can be positively influenced. This is a comprehensive source of information relating to pathogenesis, diagnosis, indications and treatment methods, incorporating the latest research findings. Radiological diagnosis is is shown as laying the foundation for successful diagnosis and treatment with manual medicine techniques. Typical conditions associated with pain in the locomotor system is presented and described in functional terms for the first time. The book concludes with chapters covering preventative aspects and expert assessment. Manipulative Therapy: Musculoskeletal Medicine is the follow on from: Manipulative Therapy in Rehabilitation of the Locomotor System, published by Butterworth Heinemann, 1985.

Rainer Thiele deals with chiropractic and examines two questions: Is chiropractic treatment of lower back pain a successful therapeutic approach? Is chiropractic treatment a standard treatment for headaches? On the topic of chiropractic in lower back pain, a congress abstract was published by the author using the latest randomized clinical studies and discussed as a poster contribution to the 16th Congress for Health Services Research in Berlin. A systematic review answers the question about chiropractic treatment of headaches. About the author: Dr. scient. med. Rainer Thiele wrote this work as part of his doctoral studies in medical science at the UFL (Private University of Liechtenstein) as a cumulative dissertation. He is managing director of the specialist practice for Chiropractic / Osteopathy and Sports Medicine in Munich.