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Manual and manipulative therapy

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About 70 to 80 percent of adults will be affected by low back pain during their lifetimes.1 Physiotherapists have several treatment options that can help patients with LBP whether due to degenerative disc disease or a variety of other causes. Physical therapy and manual therapy including spinal manipulation and patient education to remain active and use appropriate body mechanics can have positive effects and is beneficial for patients with LBP.2, 3 Physiotherapists are trained to identify which of these treatment strategies will be most effective for an individual patient, which further improves the effectiveness of care. 

 EUROPEAN ACADEMY OF MANUAL AND MANIPULATIVE THERAPY


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Physiotherapy and manual –manipulative therapy is effective for management of low-back pain

About 70 to 80 percent of adults will be affected by low back pain during their lifetimes.1 Physiotherapists have several treatment options that can help patients with LBP whether due to degenerative disc disease or a variety of other causes. 
Physical therapy and manual therapy including spinal manipulation and patient education to remain active and use appropriate body mechanics can have positive effects and is beneficial for patients with LBP.2, 3 Physiotherapists are trained to identify which of these treatment strategies will be most effective for an individual patient, which further improves the effectiveness of care. 
The previous reviews of the literature, shows how important physical therapy exercises are to improve function and decrease pain in patients with chronic LBP and that physical therapy was beneficial for the treatment of acute LBP.2, 3 "Receiving care from a licensed physical therapist can further improve the odds that a patient can maintain their quality of life and avoid surgery,". In addition to building the core muscle groups, hands-on therapy to mobilize the spine has been shown to be particularly effective. 4, 5 "Spinal manipulation can be an important component of physiotherapist treatment for low back pain. Supplementing exercise with spinal manipulation is also beneficial for many patients." 
Physical therapists can help patients develop a safe and effective exercise program that is tailored to an individual's specific needs and goals.
Often patients think of surgery as a cure but surgery should be the last option.

The European Academy of manual and manipulative therapy

Panagiotis Vitalis, MDOM, MMT , PT

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References: 
1. Andersson GB: Epidemiological features of chronic low back pain. Lancet 1999; 354:581-585.
2. Hayden JA, van Tulder MW, Malmivaara A, Koes BW: Exercise therapy for the treatment of non-specific low back pain. Cochrane Database Syst Rev. 2005;(3):CD000335.
3. Assendelft WJ, Morton SC, Yu EI, Suttorp MJ, Shekelle PG: Spinal manipulative therapy for low back pain. Cochrane Database Syst Rev. 2004;(1):CD000447.
4. Childs JD, Fritz JM, Flynn TW, Irrgang JJ, Johnson KK, Maikowski GR, Delitto A: A clinical prediction rule to identify patients with low back pain most likely to benefit from spinal manipulation: a validation study. Ann Intern Med. 2004; 141(12):920-928.
5. Chou R, Huffman LH: Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline.; American Pain Society; American College of Physicians; Ann Intern Med. 2007; 147(7):492-504.

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