CAM for back pain 2

Placebo effect
– A change in a patient’s illness due to the symbolic part of treatment rather than a scientific or pharmacological property. Based on belief that it will work.
– A self-made healing response of the body that is natural, may not even require a placebo. Mind’s effect on body
– Not completely understood

Manual therapies
– Include spinal manipulation, joint mobilization, massage
– Massage – increases local blood flow, improves lymph drainage and pain suppression mechanisms, causing tissue repair, pain reduction and improved mood.
– Osteopathic manual therapy – works on soft tissue as well as spinal manipulation. Attempts to help the body heal itself through the neuromuscular system.

Spinal manipulative therapy
– Adjusting the spine through twisting/pulling/pushing/massage/pressure to loosen/move the causes of pain (spinal bones/joint structures)
– Improves spinal mobility, supporting joint cartilage and IV discs
– Should involve exercises that strengthen the muscles to better support the joints.
– May be performed by a chiropractor, or physio
– Should not be counted on alone to treat low back pain
– Benefit is usually noticed after a single therapy, and long-term manipulation is not proven to help. Works for some but not others
– Effective short term but not long term
– Spinal manipulation shown to be equivalent to physiotherapy or exercise
– Risks due to lack of standards in field (careful with neck manipulation esp.)

http://serendip.brynmawr.edu/bb/neuro/neuro99/web1/Kinser.html
http://www.healingchronicpain.org/content/introduction/comp_manual.asp
http://www.bchealthguide.org/kbase/dp/topic/tu6488/dp.htm