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BACKACHE: A Manipulative Treatment without Anaesthesia.

The Journal of Bone & Joint Surgery: October 1938
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1. A manipulative technique performed without anaesthesia is advanced as a treatment for low-back sprain, whether it be acute or chronic.

2. The technique found its inception in the need for a means of affording immediate relief to those individuals who, in the course of some activity requiring muscle exertion, have been abruptly seized with acute back pain and rendered helpless. Later, it was found that these manipulations were equally effective in the more chronic back conditions.

3. It has been used during the past seven years in several hundred cases, yielding varying degrees of immediate relief in every instance, and gratifying recovery in the greater percentage of cases.

4. The treatment is selective in type, and its employment is restricted to those cases of low-back pain which, either directly or indirectly, are of sprain etiology, and include the following groups: anatomical variations (sacralization, impinging transverse processes, etc.), congenital anomalies, poor posture (contracted tensor fasciae latae, marked lordosis, etc.), dislocations (apophyseal subluxation, spondylolisthesis, etc.), fasciitis and myofascial syndromes, and sprains (acute or chronic) of traumatic etiology.

5. Its successful employment without anaesthetization of the patient enhances its value in emergency use.

6. Contra-indications depend upon the accuracy of the diagnosis. One presupposes satisfactory relaxation of the patient and a manipulative technique that is neither rough nor unduly forceful.

7. The post-manipulative routine emphasizes the importance of immediate and adequate bed rest; intervals of infra-red therapy and regulated exercises; the proper performance by the patient of routine every-day actions (such as getting up from a chair or sitting down, getting in and out of bed, leaning over to pick up an object, and driving his car) which, improperly done, tend to precipitate an acute exacerbation; and finally, in chronic cases, the temporary use of adequate support.

(C) 1938 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.

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