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Spinal manipulation
Spinal manipulation ?
Manipulation is frequently used in the treatment of spinal disorders. The questions however one should ask are "Why do I want to manipulate ; what do I hope to achieve with it ; how can I objectivate my procedure". I strikes me that many colleagues around the world perform spinal manipulation only on the basis of some obscure grounds. Objective elements from the history nor from the functional examination are requently missing. Mostly one claims to "feel" something ; there is a so-called segmental blocking on L4-L5 in left rotation, and this should be manipulated.
Furthermore, how are manipulations carried out : with or without a traction component ? That makes a huge difference. Some claim to manipulate the sacro iliac joint, but analysis of the manipulation performed shows that most of those procedures have as much influence in e.g. the low lumbar level. Spinal manipulation always needs to be preceeded by a objective reliable functional analysis ; we don't need "artifical hypercomplication", which is so frequent nowadays. Let's stick to basic reliable examination procedures, before to decide which treatment strategy could be beneficial.
So, I suggest not only to create a more objective diagnostic classification (cfr. McKenzie), but also to have a more logical classification or strategy of spinal manipulation. This is one the aims of modern orthopaedic medicine.
Spinal manipulation - with traction ?
Cyriax spinal manipulation maneuvers are mostly performed with a traction component in order to increase the efficiency and safety ; most of the maneuvers are aspecific. Clear indications and contraindications must be respected.
We don't perform "prophylactic" manipulations.
A specific outlined treatment strategy needs to be followed, taking into account our expectation patterns.
The complete procedure is described in every detail in our publications.
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