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Letters |2 February 1999

Spinal Manipulation: When Is It Appropriate?

Marc S. Micozzi, MD, PhD

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  • College of Physicians of Philadelphia; Philadelphia, PA 19103
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IN RESPONSE:
I agree with Dr. Deyo that the AHCPR guidelines are limited to acute low back pain, found many conventional medical treatments to be ineffective, and are lengthy and complex. I also concur that more research is needed. I appreciate his point of clarification about the lack of any formal technical cost-effectiveness analysis reported in the guideline. On reviewing the guidelines, I noted that they state that spinal manipulation relieves symptoms and improves function (while none of the other nonsurgical interventions offer both). A typical practitioner or patient may conclude that a manual (nonsurgical) treatment that works is more cost-effective than any number of treatments that don't work.
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Micozzi MS. Spinal Manipulation: When Is It Appropriate?. Ann Intern Med. ;130:238–239. doi: 10.7326/0003-4819-130-3-199902020-00031

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Published: Ann Intern Med. 1999;130(3):238-239.

DOI: 10.7326/0003-4819-130-3-199902020-00031

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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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