Consider manipulative treatment for patients who need
additional help with pain relief or who are failing to return to
|| In acute and
sub-acute back pain, manipulation provides better short-term
improvement in pain and activity levels and higher patient
satisfaction than the treatments to which it has been
|| However, there is
no firm evidence that it is possible to select which patients
will respond or what kind of manipulation is most effective.
The optimum timing for this intervention is unclear
|| The risks of
manipulation for low back pain are very low, provided patients
are selected and assessed properly and it is carried out by a
trained therapist or practitioner.
Manipulation should not be used in patients with severe or
progressive neurological deficit in view of the rare but
serious risk of neurological complication.