Indications and contraindications for chiropractic manipulation

In general, patients selected for manipulation under anesthesia have received a minimum of six to eight weeks of conservative care. Additionally, there are a number of specific indications and contraindications that need to considered prior to undertaking manipulation under anesthesia, including:

Indications

• Neck, mid back and low back pain

• Chronic muscle pain and inflammation

• Acute and chronic muscle spasm

• Decreased spinal range of motion

• Chronic fibrositis

• Nerve entrapment

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• Pseudo-sciatica

• Sciatica where disc bulges are contained less than 5 mm

• Failed back surgery

• Chronic occipital or tension headaches

• Conditions where narcotic pain relievers are of little benefit

• Traumatic torticollis

• RSD

Contraindications

Contraindication to anesthesia as determined by current medical literature and is the responsibility of the licensed medical co-manager (anesthesiologist).

Contraindications to manual manipulation of high velocity, low velocity or soft tissue techniques as established by current literature relative to technique specific for articular derangements, bone weakening and destruction disorders, circulatory and cardiovascular disorders, or neurological disorders.

Specific contraindications to manipulation of the spine under anesthesia include:

• Malignancy with metastasis to bone

• Tuberculosis of the bone

• Fractures

• Acute arthritis

• Acute gout

• Uncontrolled diabetic neuropathy

• Syphilitic articular or periarticular lesions

• Gonorrheal spinal arthritis

• Excessive spinal osteoporosis

• Evidence of cord or caudal compression by tumor, ankylosis and malacia bone disease.

• Article written By:
• Richard Reid, MD - Rosie Desimone, DC - Ben Eubank, DC

October 23, 2002

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