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New back pain guidelines

A new evidence report provides a summary of the scientific evidence, regarding the effectiveness of manual treatment for the treatment of a wide variety of conditions.
The results are based on systematic reviews of randomised controlled trials (RCT's), as well as UK and US evidence based guidelines.
 
26 categories of conditions were identified for which there was RCT evidence, 13 musculoskeletal conditions and 4 non musculo-skeletal problems. 49 recent systematic reviews, 16 evidence based guidelines and an additional 46 RCT’s not yet included in guidelines were examined.
 
Conclusions are broadly :-
1. Spinal manipulation/mobilisation is helpful for acute, subacute and chronic low back pain, migraine and cervicogenic headache, cervicogenic dizziness.
2. Manipulation/mobilisation is helpful for several extremity joint conditions.
3 Thoracic manipulation/mobilisation is effective for acute/subacute neck pain.
Evidence is inconclusive for cervical manipulation/mobilisation alone, for neck pain of any duration and for mid back pain, sciatica, tension type headache, coccydynia, temporomandibular disorders, fibromyalgia, premenstrual syndrome and pneumonia in older adults.
5. Spinal manipulation is not helpful for asthma or hypertension.
6  Evidence is inconclusive for otitis media, enuresis, colic and asthma in children and infants.
Massage is effective in adults for chronic low back and neck pain.
8. Evidence is inconclusive for massage in knee osteoarthritis fibromyalgia, myofascial pain. syndrome, migraine headache and premenstrual syndrome.
 
This is a helpful review of the available evidence to guide practitioner and patients alike


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