The Clinical Basis for Discussion of Mechanisms of Manipulative Therapy

  • Scott Haldeman

Abstract

“There is no scientific basis for manipulative therapy,” has been the most commonly stated and the most damaging criticism levied against practitioners of manipulation (Crelin, 1973; Farfan, 1973). Many noted physicians and scientists, after reviewing the available literature and research, have come to the conclusion that “there is no justification for the use of manipulative therapy” (Nachemson, 1975; Pearce & Moll, 1967; Sham, 1974). On the other hand, practitioners of manipulation feel that their clinical results are indisputable (Gitelman, 1975; Maitland, 1973; Mennell, 1960), and that there is ample experimental evidence to support their theories on how manipulation works (Cyriax, 1975; Homewood, 1963; Janse, Houser & Wells, 1947; Maigne, 1972). One reason for this dichotomy of opinion is the fact that certain basic criteria requisite for the evaluation of the rationale for any treatment have been frequently neglected.

Keywords

Placebo Migration Arthritis Depression Europe 

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References

  1. ADRIAN, E. D., and Y. ZOTTERMAN. The impulses produced by sensory nerve endings. J. Physiol. 61:151–171, 1926.PubMedGoogle Scholar
  2. BARRé, M. Sur un syndrome sympathique cervical posterieur et sa cause fréquente l’arthrite cervicale. Rev. Neurol. 33:1246–1248, 1926.Google Scholar
  3. BECHGAARD, P. Late post-traumatic headache and manipulation. Corres. Brit. Med. J., June 4:1419, 1966.CrossRefGoogle Scholar
  4. BLOOD, H. A. Manipulative management of hypertension. Acad. Appl. Osteopath. Yearbook, pp. 189–195, 1964.Google Scholar
  5. BOAKE, H. K. Cervical headache. Canadian Family Physician May: 75–78, 1972.Google Scholar
  6. BOLANDE, R. P., and W. F. TOWLER. Terminal autonomic nervous system in cystic fibrosis. Arch. Pathol. 95:172–181, 1973.PubMedGoogle Scholar
  7. BOSSHARD, R. The treatment of acute lumbago and sciatica. Ann. Swiss Chirop. Assoc., pp. 50–61, 1961.Google Scholar
  8. BRADFORD, S. G. Role of osteopathic manipulative therapy in emotional disorders: A physiologic hypothesis. J. Am. Osteop. Assoc. 64:484–493, 1965.Google Scholar
  9. BREEN, A. C. Chiropractors and the treatment of back pain. Rheumatol. Rehabil. 16:46–53, 1977.PubMedCrossRefGoogle Scholar
  10. BUERGER, A. A. Clinical trials of manipulation therapy. In: Approaches to the Validation of Manipulation Therapy, edited by A. A. Buerger and J. S. Tobis. Springfield, Ill.: Charles C. Thomas, 1976, pp. 315–321.Google Scholar
  11. BUSCH, B. W., B. D. DANELIUS, and S. F. DROST. Cardiovascular changes after chiropractic. Am. Chiropractic Assoc. J. 8: s-33–38, 1974.Google Scholar
  12. CELANDER, E., A. J. KOENIG, and D. R. CELANDER. Effect of osteopathic manipulative therapy on autonomic tone as evidenced by blood pressure changes and activity of the fibrinolytic system. J. Am. Osteop. Assoc. 67:1037–1038, 1968.Google Scholar
  13. CHRISMAN, O. D., and R. F. GERVAIS. Otologic manifestations of the cervical syndrome. Clin. Orthop. 24:34–39, 1962.PubMedGoogle Scholar
  14. CHRISMAN, O. D., A. MITTNACHT, and G. A. SNOOK. A study of the results following rotatory manipulation in the lumbar intervertebral disc syndrome. J. Bone Joint Surg. 46A:517–524, 1964.Google Scholar
  15. CLYMER, D., F. L. LEVIN, and R. H. SCULTHORPE. Effects of osteopathic manipulations on several different physiologic functions. J. Am. Osteop. Assoc. 72:204–207, 1972.Google Scholar
  16. COOTE, J. H., C.B.B. DOWNMAN, and W. V. WEBER. Reflex discharges into thoracic white rami elicited by somatic and visceral afferent excitation. J. Physiol. 202:147–159, 1969.PubMedGoogle Scholar
  17. COYER, A. B., and I.H.M. CURWEN. Low back pain treated by manipulation: A controlled series. Brit. Med. J. 1:705–707, 1955.PubMedCrossRefGoogle Scholar
  18. CRELIN, E. S. A scientific test of chiropractic theory. Am. Scientist 61:574–580, 1973.PubMedGoogle Scholar
  19. CYRIAX, R. Textbook of Orthopedic Medicine. Vol. 1, Diagnosis of Soft Tissue Lesions. 6th ed. London: Bailliere Tindall, 1975.Google Scholar
  20. DEJARNETTE, B. The Philosophy, Art and Science of Sacro-Occipital Technique. Nebraska City: B. DeJarnette, 1967.Google Scholar
  21. DORAN, D.M.L., and D. J. NEWELL. Manipulation in treatment of low back pain: A multicenter study. Brit. Med. J. 2:161–164, 1975.PubMedCrossRefGoogle Scholar
  22. DROZ, B., and C. P. LEBLOND. Migration of proteins along the axon of the sciatic nerve. Science 137:1047–1048, 1962.PubMedCrossRefGoogle Scholar
  23. DRUM, D. C., and C. M. GODFREY. Personal communication and presentation to the North American Academy of Manipulative Medicine annual meeting, October 1976.Google Scholar
  24. DUNN, F. E. Osteopathic concepts in psychiatry. J. Am. Osteop. Assoc. 49:354–357, 1950.Google Scholar
  25. ENGLAND, R., and P. DEIBERT. Electromyographic studies. Part I: Consideration in the evaluation of osteopathic therapy. J. Am. Osteop. Assoc. 72:162–169, 1972.Google Scholar
  26. FARFAN, H. F. Mechanical Disorders of the Low Back. Philadelphia: Lea & Febiger, 1973.Google Scholar
  27. FEINSTEIN, B., J.N.K. LANGTON, R. M. JAMESON, and F. SCHILLER. Experiments on pain referred from deep somatic tissues. J. Bone Joint Surg. 36A:981–997, 1954.Google Scholar
  28. FICHERA, A. P., and D. R. CELANDER. Effect of osteopathic manipulative therapy on autonomic tone as evidenced by blood pressure change and activity of the fibrinolytic system. J. Am. Osteop. Assoc. 68:1036–1038, 1969.Google Scholar
  29. FIGAR, Š., L. KRAUSOVá, and K. LEWIT. Plethysmographische Untersuchungen bei manuelle behandlung vertebragener Störungen. Acta Neuroveg. 29:618–623, 1967.CrossRefGoogle Scholar
  30. FISK, J. W. Manipulation in general practice. New Zealand Med. J. 74:172–175, 1971.PubMedGoogle Scholar
  31. FISK, J. W. The straight leg raising test: Its relevance to possible disc pathology. New Zealand Med. J. 81:557–560, 1975.PubMedGoogle Scholar
  32. FORUM. Diagnosis and treatment of uncomplicated hayfever. J. Am. Osteop. Assoc. 74:588–595, 1975.Google Scholar
  33. GALENUS. Opera Bd. IV Venetia 1625, quoted by E. H. Schiotz. Manipulation treatment of the spinal column from the medical-historical viewpoint (NIH Library Trans.). Tidsskr. Nor. Laegeforn 78:359–372, 1968.Google Scholar
  34. GARDNER, E. Physiology of movable joints. Physiol. Rev. 30:127–176, 1950.PubMedGoogle Scholar
  35. GAYRAL, L., and E. NEUWIRTH. Oto-neuro-ophthalmologic manifestations of cervical origin. New York J. Med. 54:1920–1926, 1954.PubMedGoogle Scholar
  36. GILLET, H., and M. LIEKENS. Belgian Chiropractic Research Notes. 7th ed. Brussels: Gillet and Liekens, 1968.Google Scholar
  37. GITELMAN, R. The treatment of pain by spinal manipulation. In: The Research Status of Spinal Manipulative Therapy, edited by M. Goldstein. NINCDS Monograph #15, DHEW Publ. No. NIH 76–998, 1975, pp. 277–285.Google Scholar
  38. GLOVER, J. R., J. G. MORRIS, and T. KHOSLA. Back pain: A randomized clinical trial of rotational manipulation of the trunk. Brit. J. Ind. Med. 31:59–64, 1974.Google Scholar
  39. GLOVER, J. R., J. G. MORRIS, and T. KHOSLA. A randomized clinical trial of rotational manipulation of the trunk. In: Approaches to the Validation of Manipulation Therapy, edited by A. A. Buerger and J. S. Tobis. Springfield, Ill.: Charles C. Thomas, 1977, pp. 271–283.Google Scholar
  40. GORDIENKO, A. N. Changes in bioelectric potentials of afferent nerves in immunized animal as antigen action skin receptors. Control of Immunogenesis by the Nervous System. Publication U.S. Dept. of Commerce, TT 60–51069:53–57, 1958.Google Scholar
  41. GRICE, A. A. Muscle tonus changes following manipulation. J. Can. Chiropractic Assoc. 19:29–31, 1974.Google Scholar
  42. HALDEMAN, S. What is meant by manipulation? In: Approaches to the Validation of Manipulative Therapy, edited by A. A. Buerger and J. S. Tobis. Springfield, Ill.: Charles C. Thomas, 1977, pp. 299–302.Google Scholar
  43. HALDEMAN, S. Why one cause of back pain? In: Approaches to the Validation of Manipulative Therapy, edited by A. A. Buerger and J. S. Tobis. Springfield, Ill.: Charles C. Thomas, 1975, pp. 187–197.Google Scholar
  44. HALDEMAN, S., and B. S. MEYER. The effect of experimental constriction on the structure of the sciatic nerve. South African Med. J. 44:888–892, 1970.Google Scholar
  45. HARTZMAN, G. W., and H. S. SCHWARTZ. An analysis of 350 emotionally maladjusted individuals under chiropractic care. Chapter 16 in: Mental Health and Chiropractic, edited by H. S. Swartz. New York: Sessions Publisher, 1973.Google Scholar
  46. HENDERSON, R. S. The treatment of lumbar intervertebral disc protrusion. Brit. Med. J. 2:597–598, 1952.PubMedCrossRefGoogle Scholar
  47. HOMEWOOD, A. E. The neurodynamics of the vertebral subluxation. Willowdale, Ont.: Chiropractic Publishers, 1963.Google Scholar
  48. HOOD, R. P. Blood pressure. Digest Chiropractic Econ. 16:36–38, 1974.Google Scholar
  49. HOWELL, R. K., and R. E. KAPPLER. The influence of osteopathic manipulative therapy on a patient with advanced cardiopulmonary disease. J. Am. Osteopath. Assoc. 73:322–327, 1973.PubMedGoogle Scholar
  50. HOWELL, R. K., T. W. ALLEN, and R. E. KAPPLER. The influence of osteopathic manipulative therapy in the management of patients with chronic obstructive lung disease. J. Am. Osteop. Assoc. 74:757–760, 1975.Google Scholar
  51. HUTTON, S. R. Combination of traction and manipulation for the lumbar disc syndrome. Med. J. Australia 54–1:1196, 1967.Google Scholar
  52. HVIID, H. The influence of chiropractic treatment on the rotary mobility of the cervical spine — a kinesiometric and statistical study. Ann. Swiss Chiropractic Assoc. 5:31–44, 1971.Google Scholar
  53. JANSE, J., R. H. HOUSER, and B. F. WELLS. Chiropractic Principles and Technique. Lombard, Ill.: National College of Chiropractic, 1947.Google Scholar
  54. KING, J. S. Randomized trial of the Rees and Shealy methods for the treatment of low back pain. Chapter 4 in: Approaches to the Validation of Manipulative Therapy, edited by A. A. Buerger and J. S. Tobis. Springfield, Ill.: Charles C. Thomas, 1977.Google Scholar
  55. KORR, I. M. The spinal cord as organizer of disease processes: Some preliminary perspectives. J. Am. Osteop. Assoc. 76: 89–99, 1976.Google Scholar
  56. KUNERT, W. Functional disorders of internal organs due to vertebral lesions. Ciba Symposium 13–3, 1965.Google Scholar
  57. LEWIT, K. Meniere’s disease and the cervical spine. Rev. Czechoslovak Med. 2:129–139, 1961.Google Scholar
  58. LINDSAY, J. R., and W. G. HEMENWAY. Postural vertigo due to unlimited sudden partial loss of vestibular function. Ann. Otol. 65:692–706, 1956.Google Scholar
  59. LYNESS, S. S., and A. WAGMAN. Neurological deficit following cervical manipulation. Surg. Neurol. 2:121–124, 1974.PubMedGoogle Scholar
  60. MAIGNE, R. Orthopedic Medicine — A New Approach to Vertebral Manipulations, translated and edited by W. T. Liberson. Springfield, Ill.: Charles C. Thomas, 1972.Google Scholar
  61. MAITLAND, G. D. Peripheral Manipulation, 3rd ed., 1970. London: Butterworths, 1973.Google Scholar
  62. MATTHEWS, J. A., and D. A. H. YATES. Reduction of lumbar disc prolapse by manipulation. Brit. Med. J. 20:696–699, 1969.Google Scholar
  63. MELTZER, H. Y. Skeletal muscle abnormalities in patients with affective disorders. J. Psychiat. Res. 10:43–57, 1973.PubMedCrossRefGoogle Scholar
  64. MELZACK, R., and P. D. WALL. Pain mechanisms: A new theory. Science 150:971–979, 1965.PubMedCrossRefGoogle Scholar
  65. MENNELL, J. McM. Back Pain — Diagnosis and Treatment Using Manipulative Therapy. Boston, Toronto: Little, Brown & Co., 1960.Google Scholar
  66. MENSOR, M. C. Non-operative treatment, including manipulation, for lumbar intervertebral disc syndrome. J. Bone Joint Surg, 37A: 925–936, 1955.Google Scholar
  67. METTIER, S., and C. CAPP. Neurological symptoms and clinical findings in patients with cervical degenerative arthritis. Ann. Int. Med. 14:1315–1322, 1941.Google Scholar
  68. MILLER, W. D. Treatment of visceral disorders by manipulative therapy. In: The Research Status of Spinal Manipulative Therapy, edited by M. Goldstein. NINCDS Monograph No. 15, DHEW Publication No. NIH 76–998, 1975, pp. 295–301.Google Scholar
  69. NACHEMSON, A. Intradiscal measurements of pH in patients with rhizopathies. Acta Orthop. Scand. 40:23–33, 1969.PubMedCrossRefGoogle Scholar
  70. NACHEMSON, A. A critical look at the treatment for low back pain. In: The Research Status of Spinal Manipulative Therapy, edited by M. Goldstein. NINCDS Monograph No. 15, DHEW Publication No. NIH 76–998, 1975, pp. 287–293.Google Scholar
  71. NIJIMA, A., and A. FUKUDA. Release of glucose from perfused liver preparation in response to stimulation of the splanchnic nerves in the toad. Japan. J. Physiol. 23:497–508, 1973.CrossRefGoogle Scholar
  72. NORMAN, J., and J. G. WHITMAN. The vagal contribution to changes in heart rate evoked by stimulation of cutaneous nerves in the dog. J. Physiol., London 234:89P–90P, 1973.Google Scholar
  73. NORRIS, T. A study of the effect of manipulation on blood pressure. Acad. Appl. Osteopath. Yearbook: 184–188, 1964.Google Scholar
  74. PALMER, D. D. The Science, Art and Philosophy of Chiropractic. Portland, Ore.: Portland Printing House Co., 1910.Google Scholar
  75. PARE, A. Opera, Liber XV, S. 440–440, Paris, 1582, quoted by E. H. Schiotz. Manipulation treatment of the spinal column from the medical-historical viewpoint (NIH Library translation). Tidsskr. Nor. Laegeforn 78:359–372, 1958.Google Scholar
  76. PEARCE, J., and J.M.H. MOLL. Conservative treatment and natural history of acute disc lesions. J. Neurol. Neurosurg. Psychiat. 30:13–17, 1967.CrossRefGoogle Scholar
  77. PERL, E. R. Pain: spinal and peripheral factors. In: The Research Status of Spinal Manipulative Therapy, edited by M. Goldstein. NINCDS Monograph No. 15, DHEW Publication No. NIH 76–998, 1975, pp. 173–182.Google Scholar
  78. PERL, E. R., and D. G. WHITLOCK. Somatic Stimuli exciting spinothalamic projections to thalamic neurons in cat and monkey. Exp. Neurol. 3:356–396, 1961.CrossRefGoogle Scholar
  79. PRATT-THOMAS, H. R., and K. E. BERGER. Cerebellar and spinal injuries after chiropractic manipulation. J. Am. Med. Assoc. 133:600–603, 1947.PubMedCrossRefGoogle Scholar
  80. QUIGLEY, W. H. Physiological psychology of chiropractic in mental disorders. Chapter 10 in: Mental Health and Chiropractic -A Multidisciplinary Approach, edited by H. S. Schwartz. New York: Sessions Publishers, 1973.Google Scholar
  81. RIMON, R., A. STENBACK, and E. HUCKMAN. Electromyographic findings in depression Patients. J. Psychosom. Res. 10:159–170, 1966.PubMedCrossRefGoogle Scholar
  82. ROBERTSON, A.H.M. Manipulation in cervical syndrome. The Practitioner 200:396–402, 1968.PubMedGoogle Scholar
  83. ROGERS, J. T., and J. C. ROGERS. The role of osteopathic manipulative therapy in the treatment of coronary artery disease. J. Am. Osteop. Assoc. 76:71–81, 1976.Google Scholar
  84. RUXIN, R. L., T. G. BIDDER, and D. P. ANGLE. The influence of autonomic arousal on blood clotting time in patients receiving electroconvulsive treatments. J. Psychosom. Res. 16:185–192, 1972.PubMedCrossRefGoogle Scholar
  85. SATO, A., and R. F. SCHMIDT. Somatosympathetic reflexes: afferent fibers, central pathways, discharge characteristics. Physiol. Rev. 53:916–947, 1973.Google Scholar
  86. SHAM, S. M. Manipulation of the lumbosacral spine. Clin. Orthop. Related Res. 101:146–150, 1974.Google Scholar
  87. SIEHL, D., D. R. OLSON, H. E. ROSS, and E. E. ROCKWOOD. Manipulation of the lumbar spine with the patient under general anesthesia: Evaluation by electromyograph and clinical-neurologic examination of its use for lumbar root compression syndrome. J. Am. Osteop. Assoc. 70:433–437, 1971.Google Scholar
  88. STERNBACH, R. A., S. R. WOLF, R. W. MURPHY, and W. H. AKESON. Traits of pain patients: the low-back “loser”. Psycho somatics 14:226–229, 1973.Google Scholar
  89. STEIN-WERBLOWSKY, R. The sympathetic nervous system and cancer. Exp. Neurol. 42:97–100, 1974.PubMedCrossRefGoogle Scholar
  90. STILES, E. G. Osteopathic manipulation in a hospital environment. J. Am. Osteop. Assoc. 76:243–258, 1976.Google Scholar
  91. STILL, A. T. Philosophy of Osteopathy. Kirksville: A. T. Still Publisher, 1899.Google Scholar
  92. SWAN, B. Cervical manipulation. Med. J. Australia 2:811, 1968.PubMedGoogle Scholar
  93. The Manipulation Project. California College of Medicine, University of California, Irvine. Preliminary Report: Effect of rotational manipulation of the pelvis and lumbosacral spine on straight leg raising. Submitted for publication, 1977.Google Scholar
  94. TISSINGTON-TATLOW, W. F., and H. G. HAMMER. Syndrome of vertebral artery compression. Neurology 7:331–340, 1957.PubMedGoogle Scholar
  95. TRAN, T. A., and J. D. KIRBY. The effects of upper cervical adjustment upon the normal physiology of the heart. Am. Chiropractic Assoc. J. 11:S-58–62, 1977.Google Scholar
  96. VEAR, H. J. A study into the complaints of patients seeking chiropractic care. J. Canad. Chiropractic Assoc. Oct.:9–13, 1972.Google Scholar
  97. WARR, A. C., J. A. WILKINSON, J.M.B. BURN, and L. LANGDON. Chronic lumbosciatic syndrome treated by epidural injection and manipulation. The Practitioner 209:53–59, 1972.PubMedGoogle Scholar
  98. WEISS, P. Endoneurial edema in constricted nerve. Anat. Rec. 86:491–522, 1943.CrossRefGoogle Scholar
  99. WEISS, P., and H. B. HISCOE. Experiments on the mechanism of nerve growth. J. Exptl. Zool. 107:315–395, 1948.CrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1978

Authors and Affiliations

  • Scott Haldeman
    • 1
  1. 1.Department of NeurologyUniversity of CaliforniaIrvineUSA

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