The effect of manipulation on law back pain treatment

Name
University
Tutor
Subject
Date
A research proposal on effects caused by spine manipulation therapies in patients during treatment of lower back pain
1.0 Abstract
Back pains are increasingly becoming common among the current generation. This problem has mad it necessary for medical practitioners to device multiple ways of treating the ailment (Santilli et al., 2006, p. 56). Manipulation on lower back is one of the methods currently used to deal with this problem. However, there have been varied opinions about effectiveness of this method with several controversial opinions being given by different quotas of the medical profession. Considering the effects this problem on its victims, there is need to urgently research of possible and most effective means of dealing with it (59). This research proposal seeks to investigate the various theoretical and practical phenomena that circumvent the overall problem. It also seeks to employ the best data collection and analysis procedures to come out with the best result reflecting the truancy surrounding these medical beliefs. Unless proper investigations are carried out about the use of manipulation on lower back to treat back pains, then the problem is going to remain a puzzle to many people including health professionals thus making it difficult to treat.
2.0 Purpose of the study
Health practitioners such as chiropractors, osteopaths, and physical therapist have tried to treat back pain using different methods and among them is manipulation on lower back (Lehman et al., 2001, p. 79). This therapy has however received mixed opinions about it effectiveness to treat lower back pains. Some people have opted for alternative treatment after manipulation on lower back has failed. Some have always preferred this method as they find it effective and simple to administer. A question about its reliability and effectiveness then arises. This study aims at evaluating these claims by investigating various beliefs associated with this method of treatment. The purpose is to investigate what the real situation is like at the ground and eventually be able to compile a report that can aid in improving treatment of back pains.
3.0 Research questions
This research project will be guided by a set of questions. These questions are designed in a manner that they focus on the study problem, which is the effect of manipulation on lower back in pain treatment. These questions will be as follows;
What effects does the manipulation on lower back in pain treatment have on patients suffering this problem?
What perceptions do medical practitioners hold on this method of treating lower back pain?
How effective is manipulation on lower back in pain treatment?
What available options are considerable in treating lower back pain?
What should be done in dealing with effects of manipulation on the lower back in pain treatment?
These set of questions will be very useful in addressing the thesis of this research proposal. In-depth considerations of other issues articulated to the weight surrounding these questions will also be highlighted. Answers to these questions will in a big way serve to address the entire issue on effects associated with manipulation of lower back in pain treatment.
4.0 Research design
A descriptive design is the most suitable for this research. This kind of design seeks to observe and describe various parameters associated with the research topic or question. Data collection will be done using questionnaires indicating that the design is also survey oriented. The design of this research will be based on five major components of an ideal design. These components ensured that the design is systematic and that it focuses on the research questions throughout the exercise. The components are:
Goals; this has assisted much in establishing why the research was worth doing. In this case, worthiness of this research was proved by the fact that spinal manipulations are having many effects some of which can be physically identified while others must undergo clinical analysis to establish.
Conceptual framework; current proceeding thought to be going on within the medical field aid much in data collecting and interpretation. The existing theories that revolve around the whole issue of spinal manipulations will be used to arrive at the most effective interview questions. A good literature review done further will ensure proper focus on both doctor and patient views. Therefore, a proper understanding of the issue will make it easier to settle some of the most contentious issues in a research such as the sample size and time schedules for the whole exercise.
Research questions; this component assist much in isolation of what is known from what is not known about the research topic Specific details about what the research will be investigating will be easily revealed in the questions since no repetitive and obvious data can be collected when this is put in and adhered to. Both patients’ and doctors’ are in no doubt good candidates for these research questions. This means that the questions were designed in a manner that they consistently and cohesively relate to one another and the research topic.
Methods; it is the most important component of a research design as it highlights what is to be done in a research. In line with the sensitivity that health matters have, quantitative and qualitative approaches are preferable. Proper means of establishing a sound relationship with respondents will come out clearly at this stage since sources have been selected. Venues of data collection are also affirmed with data analysis methods being determined too.
Validity; design for this research also focuses on possible factors that could probably invalidate the results. Interpretation threats that could emerge at the end have been avoided by thorough scrutiny of the research questions and better options put in place incase of any eventuality in validity challenges. The efforts are aimed at making results obtained more reliable and valid for that matter to prompt a sense of believe in the results. These validity assurances are in no doubt able to convince anybody beyond any reasonable doubt to believe in the results.

5.0 Aims and objectives
The effects of manipulation on lower back in pain treatment form the plat form of the main aim of this research. All efforts are directed to establishing the most pronounced effects and how they manifest themselves. The most effective tools and techniques of identifying these effects will be utilized to come up with clear professional and unprofessional perspectives about the effects of manipulation on the lower back in pain treatment. This project aims to expose effects associated with manipulation on lower back pain treatments, their remedies and alternative avenues that can be used to counteract them.
6.0 Literature review
6.1 Introduction to the topic
Lower back pain is a condition that has proved more difficult to treat (Hurwitz et al., 2006, p. 477). Treatments directed at this conditions are mainly aimed at relieving pain but not necessary heal the condition. In other words, it can be said that these efforts are aimed at improving functioning rather than reinstating it. Guidelines used by health care practitioners have experienced the inclusion of manipulation on lower back treatment in the recent past. Mostly medical practitioners such as chiropractors and physical therapists use spinal manipulations to relieve lower back pains. It is effected by physical application of force to the spine which depends on the kind of manipulations used. Either using the hands or a machine for this treatment has proved functional when spine is moved beyond its passive range of motion causing relief to back pains (Tulder, 2006, p. 372). This is a good indicator that the procedure has the ability to treat lower back pain just like any other conventional treatment.
6.2 Status on spinal manipulation therapy
Studies have shown that this method is effective and does not come with very serious side effects, as it is the case in conventional treatment. Treated areas experience some sort of discomfort for a sort period approximately 1-2 days and subsequently the discomfort goes away (Tulder, 2006, p. 381). There are few cases of serious complications. This has attracted a lot of attention from both heath professionals and patients leading to an extensive research initiative about lower back pain treatment. Healthcare professionals have gone ahead to encourage their patients to reveal any alternative or complementary methods they could be using at home and that is related to manipulation of the spine for them to gain more insight into it.
Studies in the US have shown that everyone experience back pain at least once in life. According to Keller and Colloca (2000, p. 591), the pains cannot be associated with any causative agent apart from cases where there is direct linkages to certain known stimuli. This is to say that unless the doctor or the patient did something like falling or introduced some harmful elements into their body, these pains cannot be linked to something else. Almost a quarter of adults in the US experience lower back pains each year (617). For most of them, the pains last for a few weeks irrespective of whatever kind of treatment was used. These pains can become chronic in some cases thus making it very difficult to treat and study.
6.3 Validity of this therapy
Manipulation on lower back is accepted for of treating lower back pain in the US. Chiropractors practice their profession mainly on people with back pains and the practice is generally referred to as adjustment (Souvlis et al. 2005, p. 396). The American Pain Society and the American College of Physicians included spinal manipulations in their guidelines in 2007 as an alternative method that the problem could be approached with if self-care was ineffective. Ferreira et al. (2006, p.596) assert this to the fact that it was after it emerged that spinal manipulation provides relief only after three months of application. The studies further revealed that relief could continue for a period of up to one year or more.
The National Center for Complementary and Alternative Medicine (NCCAM) in the United States carried out a study on effectiveness of the therapy and discovered that relief could last for an average of 18months after application (Suter et al. 2005, p.671). However, the study revealed that in 20 percent of these individuals, relief could not hold for up to 18 months irrespective of the method used top apply this therapy. However, this study concluded that spinal manipulations are as effective as any other acceptable conventional treatments to lower back pains.
6.4 Side effects associated with spine manipulations
Spinal manipulation continues to receive much backing from different healthcare professionals mainly because it has fewer side effects (Souvlis et al. 2005, p. 393). Common side effects are very mild and could last for one to three days. These effects include tiredness, headache and the most prevalent in many cases, discomfort on the treated areas (395). This shows that the practice is generally safe to undergo therefore making more people go for it.
Some studies have also revealed some indefinite serious complications that come with this therapy. The most serious of them is a condition called cauda equina syndrome, which make nerves in the lower region of the spine to compress (Rakel & Faass, 2006, p. 103). This result in severe pain accompanied by general body weakness and could eventually lead to loss of feeling in either one or both legs. These complications could be fatal as the patient may end up unable to walk properly. Although cauda equina is very rare, it causes loss of control in bowel as well as the bladder. Cauda equina is not worsened in any way by spinal manipulations in patients whose back pains are caused by a herniated disc.
6.5 Effects on neural tissue within the inter-vertebral foramen
As already revealed, spinal manipulation involves application of force on the spine which relives pain. This has a huge impact on the inter-vertebral foramen because of its biological structure. Studies show that there is prove beyond any reasonable doubt that dorsal roots and the dorsal root ganglia are affected very much by application of force on the vertebral column (Suter et al., 1999, p.669). Loads of up to 10mg increases the release of group I, II, III, and IV efferents. Continued bombardment of the sensory structures causes a lot of pain around the spine, which further worsen the condition and causing more pain.
Patients who have undergone this therapy have suffered massive intimal tearing of their vertebral arteries (Szpalski, et al., 2010, p. 72). This has necessitated surgical interventions to deal with such problems, which mostly occur at the level of the atlantoaxial joint. Intimal tears are normally accompanied by intramural bleeding or formation of pseudoaneurysm, which results, into an embolism, arterial spasm, or thrombosis (77). This problem is associated to countries that are more developed. Chiropractors in these countries have been observed to use spinal manipulations in most of their back pain therapies, a reason that is perhaps the most appropriate to explain this trend. Most data collectively show that spinal manipulations are the most responsible for mild and adverse effects that may happen to be frequent. These effects have been linked to causing permanent disa...