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Adjustments/Manipulation
Sari H. Computed Tomographic Evaluation of Lumbar Spinal Structures During Traction. Physiother Theory Pract. 2005 Jan-Mar; 21 (1):3-11

There is Radiological evidence that traction of acute Lumbar Disc Herniation (LDH) will provide a reduction of the size of the herniation, increased space within the spinal canal, widening of the neural foramina, and decreased thickness of the psoas muscle


Gudavalli R. A Randomized Clinical Trial and Subgroup Analysis to Compare Flexion-Distraction with Active Exercise for chronic Low Back Pain. Eur Spine J. 2005

Patients with chronic low back pain perceived significantly less pain regardless of what group (Flexion-Distraction vs. Active Exercise) they were in. Patients in the Flexion-Distraction group had significantly greater relief of perceived pain according to VAS then in active exercise. Patients with chronic, moderate to severe symptoms, and radiculopathy improved most with Flexion-Distraction technique versus active exercise.


Murphy DR. A Non-Surgical Approach to the management of Lumbar Stenosis: A Prospective Observational Cohort Study. BMC Musculoskeletal Disorders. 2006; 7. Feb 23 2006

Lumbar spinal stenosis patients improved by 76% and disability improved in 73%. Patients with Lumbar Spinal Stenosis (LSS) may improve significantly with a treatment approach focusing on Distraction Manipulation.


Julita A. Spinal Manipulation Therapy Reduces Inflammatory Cytokines but not Substance P Production in Normal Subjects. JMPT. 2006 Jan; 29 (1):14-21

Spinal Manipulation (Chiropractic Adjustments) on patients shows a "time-dependant attenuation" of (lipopolysaccharide)-induced production of inflammatory cytokines. In other words, manipulation can help lower inflammation in the body.


Bronfort G. Efficacy of Spinal Manipulation and Mobilization for low back and neck pain: a systematic review and best evidence synthesis. Spine 4 (2004) 335-356.

a. Reviewing the literature on spinal manipulation, the data suggests that:
  • Acute Low Back Pain: Moderate Evidence that spinal manipulation will provide more short-term relief than mobilization and detuned diathermy, and a small amount of evidence exists that there is a faster recovery than a commonly used physical therapy strategy.

  • Chronic Low Back Pain: There is a moderate amount of evidence that suggests that manipulation has an effect similar to an efficacious prescription anti-inflammatory medication.

  • Chronic Neck Pain: Moderate evidence exists that manipulation and mobilization is superior to general practitioner management for short-term pain reduction.
b. These points make spinal manipulation a viable option for care of the stated conditions.


Pickar J. Neurophysiological effects of spinal manipulation. (Review Article) Spine 2 (2002) 357-371.

Spinal manipulation impacts proprioceptive primary afferent neurons (in other words, sensory input to our brain) from paraspinal muscle tissue. Manipulation may also affect pain processing in the brain possibly by altering central facilitation or central sensitization state (increased excitability) of the spinal cord.


Xue-Jun Soung. Spinal manipulation Reduces Pain and Hyperalgesia after Lumbar Intervertebral Inflammation in the Rat. JMPT, 2006;29:5-13

Activator Assisted Spinal Manipulative Therapy (ASMT) can significantly reduce severity and shorten duration of pain and hyperalgeisa caused by lumbar IVF inflammation.
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