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Spinal manipulation: Indications, risks and benefits

Journal: Journal of Osteopathic Medicine Date: 2001/04, 4(1):Pages: 34. doi: Subito , type of study: article

Full text    (https://www.sciencedirect.com/science/article/pii/S1443846101800551)

Keywords:

article [2076]
high velocity low amplitude [39]
HLVA [9]
spine [339]
abstract [165]

Abstract:

High velocity low amplitude (HVLA) thrust techniques are widely used by many manual medicine disciplines to treat spinal dysfunction. Techniques of this type are associated with an audible release in the form of a pop or cracking sound that is widely accepted to represent cavitation of a spinal zygapophysealjoint. This audible release distinguishes HVLA thrust techniques from other manual medicine interventions. Common indications for the use of HVLA thrust techniques are 'joint fixation', 'joint locking' and somatic dysfunction but various authors have also described other indications for the therapeutic use of these techniques. Despite a wide range of indications, there has been a decline in the use of HVLA thrust techniques, Concern regarding patient safety and the difficulty associated with gaining mastery of HVLA thrust techniques may be reasons for the decline in their use. While there are potential serious sequelae from the use of HVLA thrust techniques, the risks are low provided patients are thoroughly assessed and treated by appropriately trained practitioners. With increasing evidence that spinal manipulation produces positive patient outcomes for acute low back pain and some categories of neck pain and headache, there is a need to look critically at the indications for the use of HVLA thrust techniques as well as the actual risks and potential benefits of this therapeutic modality.


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