Lumbar Spine and Chiropractic Procedures: Movements and Changes
IN BRIEF
TECHNIQUE
William J. Owens
Jr. DC DAAMLP CPC
Chiropractic care plays a big role in the diagnosis and management of nonspecific spine pain. Research is demonstrating positive outcomes, and we are starting to see discussions relating to the actual mechanism of its effectiveness. A recent paper by Gudavalli et al. (2023) reported, “The objectives of this study were to quantitatively detennine (1) intervertebral motions and (2) changes in IVF area, height, and width in the lumbar spine during the application of a chiropractic procedure known as the Cox fiexion-distraction” (p 8).
The paper continued by stating, “Chiropractic care seems to be more effective than conservative intervention for LBP [low back pain] in reducing pain, increasing range of motion in lumbar spine, improving disability status, and enhancing general health” (p 8). The authors continued, “Manipulative procedures have been used for the treatment of LBP and are recom-mended for patients with LBP. S everal types of chiropractic manipulative procedures are available for treating LBP, including high-velocity, low-amplitude spinal manipulations, traction-based procedures, and instrument-assisted very high-velocity, low-amplitude techniques” (p 8). The application of specific techniques is generally related to the individual patient, their diagnosis, and any underlying comorbidities that are present.
The paper continued by reporting, “One of the hypotheses of spinal manual treatments is that the vertebral motion occurs as a result of the application of force during manual treatment. This leads to improvements in the lumbar spine function” (p 8). Restoration of vertebral body motion is a key tenant in the management of nonspecific spine pain. The paper also stated, “Intervertebral motions and IVF dimensional increases were noticed during the flexion-distraction procedure” (p 7).
In conclusion, the authors outlined, “The Cox flexion-distraction chiropractic procedure created vertebral movements at L4-L5 and L5-S1 levels. It also increased IVF dimensions at L4-L5 and L5-S1 levels based on unembalmed, whole-cadaver experiments” (p. 12). This is important and supports the foundation that restoration of mechanical motion in the human spine helps manage dysfunction and pain syndromes.
Dr. William Owens Jr. is currently in private practice in Buffalo, New York. He is president and CEO of the National Spine Management Group, LLC and clinical director of the Fellowship in Spinal Biomechanics and Trauma, and adjunct faculty in Family Medicine at the SUN Y at Buffalo Jacobs School of Medicine and Biological Sciences, and Cleveland University Kansas City, College of Chiropractic. Contact him at 716-228-3847.
Reference:
1. Gudavalli, M. R., Cramer, G. D., & Patwardhan, A. G. (2023). Intervertebral movements and changes in intervertebral foraminal morphology in the lumbar spine during a chiropractic procedure: A cadaveric study. Integrative Medicine Reports, 2(1), 7-13.
