Chiropractic technique procedures for specific low back conditions: characterizing the literature.
BACKGROUND
Many original clinical trials and several review papers have come to the conclusion that manipulation is safe and effective for the treatment of low back pain. However, it is necessary to determine which specific types of manipulation and nonmanipulative types of chiropractic adjustive care are most effective for particular types of low back pain across both tissue-specific and functional classifications.


OBJECTIVE
To characterize the quantity and quality of literature gathered for an Expert Panel that was convened to rate various specific chiropractic adjustive procedures for the treatment of common types of low back pain, drawing on the clinical expertise of the panel members and the relevant literature.


METHODS
Systematic review of treatment-specific, condition-specific trials, studies, and case reports of chiropractic care for low back pain.


METHODS
Computerized searching and hand searching were used to identify references in the medical and chiropractic literature pertaining to the chiropractic treatment of low back pain in which both the condition and specific treatment procedures were adequately described. This literature was then categorized according to a variety of characteristics and used by a panel to evaluate the specific procedures.


RESULTS
The 3 most studied adjustive procedures are side-posture high-velocity, low-amplitude; distraction (mostly flexion distraction); and mobilization, respectively. The clinical condition most commonly addressed by the included studies is low back pain. The procedure with the widest base of evidence support is side posture manipulation for low back pain.
Cooperstein
R
R
Palmer Chiropractic College West, San Jose, CA 95134, USA.
Perle
S M
SM
Gatterman
M I
MI
Lantz
C
C
Schneider
M J
MJ
D002684:Chiropractic / Q000379:methods*; D017408:Guidelines as Topic; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*