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The Somatic Connection  |   January 2015
Spinal Manipulation Improves Pain Perception, Spinal Mobility, and Height in Men With Degenerative Disk Disease
Article Information
The Somatic Connection   |   January 2015
Spinal Manipulation Improves Pain Perception, Spinal Mobility, and Height in Men With Degenerative Disk Disease
The Journal of the American Osteopathic Association, January 2015, Vol. 115, 52-53. doi:10.7556/jaoa.2015.010
The Journal of the American Osteopathic Association, January 2015, Vol. 115, 52-53. doi:10.7556/jaoa.2015.010
Web of Science® Times Cited: 3
Vieira-Pellenz F, Oliva-Pascual-Vaca Â, Rodriguez-Blanco C, Heredia-Rizo AM, Ricard F, Almazän-Campos G. Short-term effect of spinal manipulation on pain perception, spinal mobility, and full height recovery in male subjects with degenerative disk disease: a randomized controlled trial. Arch Phys Med Rehabil. 2014;95(9):1613-1619. doi:10.1016/j.apmr.2014.05.002. 
Degenerative disk (DD) disease is the most common cause of low back pain (LBP) in adults and accounts for 90% of surgical procedures performed on the back.1 Studies have sought to understand the role of spinal manipulation (SM) in this population; however, the data are conflicting. Some evidence suggests that SM decreases pain and improves function in patients with intervertebral disk disease.2 Others hypothesize that structural disruption of a DD may lead to a loss of intervertebral disk height and spinal range of motion3; however, it remains unclear whether SM has these effects. The authors set out to determine whether high-velocity, low-amplitude (HVLA) manipulation of the lumbosacral spine has an immediate effect on LBP, spinal mobility, and participant height. 
Inclusion criteria were men aged between 18 and 55 years, body mass index between 20 and 25, presence of LBP, and magnetic resonance imaging evidence of lumbosacral disk degeneration. Exclusion criteria included professional athletics, unstable disk herniation, cauda equina syndrome, surgery for DD disease, radicular pain with neurologic signs, or SM within 3 months. 
A total of 40 men were randomly assigned to the treatment group (n=20) or the control group (n=20). The treatment group underwent 1 SM performed by a physical therapist using the lateral recumbent HVLA to the lumbosacral spine maneuver, and the control group underwent sham therapy, with similar positioning as the treatment group but without segment tension or thrust. Measurements were taken 3 minutes before and 3 minutes after intervention, including self-perceived LBP (visual analog scale), passive straight-leg raise range of motion (goniometer), spinal mobility in flexion (finger-to-floor distance test), and participant height (stadiometer). 
Pre- and postintervention intragroup difference analyses showed significant differences in the treatment group across all variables (P<.001). In contrast, the finger-to-floor distance test results were significant in the control group (P=.008). From before to after the intervention, the between-group comparison of mean differences were significant across all variables (P<.001). Minimum important differences that indicated notable change in clinical status were met for all variables except perceived LBP. A 45.94% pre- to postintervention change was observed for perceived LBP, with a minimum important difference greater than 50%. The authors concluded that HVLA to the L5-S1 joint has immediate positive effects on LBP, spinal mobility, and height in men with DD disease. (doi: 10.7556/jaoa.2015.010) 
Katherine Markelz, OMS III 
Western University of Health Sciences College of Osteopathic Medicine of the Pacific (WesternU/COMP)-Northwest, Lebanon, Oregon 
Michael A. Seffinger, DO 
WesternU/COMP, Pomona, California 
References
An HS, Anderson PA, Haughton VM, et al.  . Introduction: disc degeneration: summary. Spine (Phila Pa 1976). 2004; 29(23): 2677-2678. [CrossRef] [PubMed]
Burton AK, Tillotson KM, Cleary J. Single-blind randomized controlled trial of chemonucleolysis and manipulation in the treatment of symptomatic lumbar disc herniation. Eur Spine J. 2000; 9(3): 202-207. [CrossRef] [PubMed]
Beattie PF. Current understanding of lumbar intervertebral disc degeneration: a review with emphasis upon etiology, pathophysiology, and lumbar magnetic resonance imaging findings. J Orthop Sports Phys Ther. 2008; 38: 329-340. [CrossRef] [PubMed]