Lumbar Spine and Chiropracti­c Procedures

Chiropractic care plays a big role in of the diagnosis and management of non-specific spine pain.  More and more 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) wrote, “The objectives of this study were to quantitatively determine (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 flexion–distraction.” ^{(pg 8)}

The paper continues by reporting, “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.” ^{(pg 8)} The authors continue by stating, “Manipulative procedures have been used for the treatment of LBP and are recommended for patients with LBP.  Several 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.” ^{(pg 8)} The application of specific techniques is generally related to the individual patient, their diagnosis and any underlying co-morbidities 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.” ^{(pg 8)} Restoration of vertebral body motion is a key tenant in the management of non-specific spine pain.  The paper continues, “Intervertebral motions and IVF dimensional increases were noticed during the flexion–distraction procedure.” ^{(pg 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.” ^{(pg 12)} This is important and supports the foundation that restoration of mechanical motion in the human spine helps to management dysfunction and pain syndromes.

REFERENCES: 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.