Spinal manipulation and mobilization
Manual manipulation of the spine has been used by clinicians for thousands of years and continues to be a commonly used technique. The goal of manipulation is to restore maximal, pain-free movement of the musculoskeletal system in postural balance. In the past decade, there has been a significant growth in evidence supporting the benefits of spinal manipulation and mobilization techniques. Spinal manipulative techniques are high-velocity, low-amplitude maneuvers that force an individual vertebra against a restriction, just beyond its passive range of motion, and back into it's normal alignment. These techniques produce a palpable and sometimes auditory articulation. Mobilization techniques, on the other hand, are broadly defined as manual movement of a joint through it's full passive range of motion with no thrust. The current evidence shows that both spinal manipulation and mobilization techniques are effective options for treatment of low back pain and that manipulation decreased pain and improved range of motion in patients with chronic neck and low back pain. Furthermore, clinical studies have clearly demonstrated a significant decrease in medication use in patients who undergo manual manipulation treatments.