Use of manipulative therapy for mechanical pain of spinal origin.

Manipulation of the spinal joints for the relief of pain is an ancient remedy that is in widespread use today. Clinical trials investigating the effectiveness of manipulative therapy are briefly reviewed, and some experimental evidence suggesting possible causes of spine pain is presented. The rationale for the use of spinal manipulative therapy within the context of R. A. McKenzie's diagnostic and therapeutic system is detailed and explicitly stated. Spinal mobilization and manipulation are presented as a logical treatment progression from the use of postural instruction and exercise therapy. Extensive description of technique is not given, but the clinical signs that indicate the need to use or avoid mobilization and manipulation in a particular direction are detailed.