Translated Titles

Diagnostic Triage and Manipulation for Low Back Pain




汪作良(Tso-Liang Wang)

Key Words

下背痛 ; 手法矯治 ; low back pain ; manipulation



Volume or Term/Year and Month of Publication

23卷3期(2019 / 05 / 25)

Page #

353 - 361

Content Language


Chinese Abstract


English Abstract

Low back pain (LBP) is a very common complaints seen in daily practice, of which the prevalence is only second to common cold. Most patients with LBP do not need surgery. Therefore, the importance of conservative treatment for LBP cannot be overemphasized. Manipulation has been regarded as an aggressive conservative treatment because of its ability to correct pathomechanics. The key successful factors of manipulation are selecting appropriate patients and making a correct diagnosis. Therefore, a diagnostic triage system is important to accomplish successful manipulations. LBP can be categorized into two major groups: non-mechanical LBP and mechanical LBP. As to "non-mechanical" LBP, such as LBP caused by tumor, infection, collagen diseases, psychological problems and central sensitization, manipulation is usually not indicated. Manipulation is indicated in "mechanical" LBP which is further divided into two groups: specific LBP and non-specific LBP. The "specific" LBP is the LBP of which the cause can be seen on imaging studies, such as spondylolisthesis, spodylolysis, and disc protrusion. These structural changes have the tendency to present with pseudo-positive findings in imaging studies. The "non-specific" LBP indicates the LBP of which the cause cannot be seen on imaging studies. It is hard to make a precise diagnosis for it because of its variability in etiology. The differential diagnostic list of non-specific LBP includes articular dysfunctions (the facet joint, the sacroiliac joint, etc.), myofascial dysfunctions, motor control dysfunctions and peripheral sensitization. In conclusion, Non-specific LBP can be treated by correcting its pathomechanics through manipulation together with taping, bracing and home exercises under precise diagnosis.

Topic Category 醫藥衛生 > 醫藥衛生綜合
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