A friend of mine, a local MD, stopped by yesterday to drop his daughter off at my daughter’s birthday party. As we talked, I saw him reach for his low back. I asked him what was up. He said his back started hurting a week ago. He’s a doctor, so I explained to him the new science behind best treatments for acute low back pian. In so doing, I shared with him what some top physical therapists have defined as a new clinical prediction rule (CPR) for low back pain.
The CPR includes five factors which, when present, provide a classification for patients as appropriate for spinal manipulation. When all five factors are present and the patient receives spinal manipulation, there is a 95 percent result. If only two of five factors are present and the patient receives spinal manipulation, there is a 45 percent result. Not bad to have nearly a 50-50 chance of getting better with this low risk approach. The risk-side is that if people are not appropriately classified and so treated, they unfortunately run the risk of sliding along the slippery slope toward chronic and recurring back pain.
Anyway, as we talked, I mater-of-factly pointed over to my portable mat table sitting against the living room wall. The doctor took me up on my offer to receive spinal manipulation. I first checked him out, and he had all five factors. I manipulated his low back, and he got up with complete pain freedom.
He was able to move through a full range of movement with no pain at all. He left right afterward, and the birthday party got into full tilt. Upon his return to pick up his daughter two hours later, he shared with me his bewilderment that he could be completely free of back pain.
Folks, we shouldn’t be bewildered when we rely on today’s science to guide us in the best physical therapy treatment for the right patient.
The five factors that make up the CPR for spinal manipulation are:
1. Low back pain with onset less than 16 days
2. Symptoms not radiating below one knee
3. One or both hips with good rotation
4. Reduced mobility in at least one level in the low back
5. Minimal fear of movement
For more on spinal manipulation available at Alpine Physical Therapy, listen to this informative podcast with Brent Dodge by clicking here.