Effective lower back pain management for adolescents and children needs both conditioning and manipulation says a new study

Effective lower back pain management for adolescents and children needs both conditioning and manipulation says a new study

Many studies state the effectiveness of physiotherapy or manipulation for back pain. Many of our patients have learned that a combined approach of both manipulation and exercises with myofascial release treatment in a more active care regimen is how they improved. The sad news is that most treatments, surgical and non for lower back pain fail because the mechanism behind the pain is misunderstood and the treatment approach is geared toward symptomatic regions rather than understanding the reason for the pain and applying a methodology that takes that understanding and applies a rational or knowledgeable solution to find a resolution of the symptoms.

In the adolescents and children most often seen, the problems are not very different than those found in adults, except the adults have degenerative processes that began because the original cause was never properly diagnosed, advised and then treated.

This new study confirms what our office has used in its protocols of active care and active evaluation has known for years. Read it below

Physical therapy treatments for low back pain in children and adolescents: a meta-analysis

Inmaculada Calvo-Muñoz1*, Antonia Gómez-Conesa1 and Julio Sánchez-Meca2

* Corresponding author: Inmaculada Calvo-Muñoz inmaculada.calvo@um.es

Author Affiliations

1 Department of Physiotherapy, Faculty of Medicine, Espinardo Campus, University of Murcia, Murcia 30100, Spain

2 Department of Basic Psychology and Methodology, University of Murcia, Murcia, Spain

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BMC Musculoskeletal Disorders 2013, 14:55 doi:10.1186/1471-2474-14-55

Published: 2 February 2013




Low back pain (LBP) in adolescents is associated with LBP in later years. In recent years treatments have been administered to adolescents for LBP, but it is not known which physical therapy treatment is the most efficacious. By means of a meta-analysis, the current study investigated the effectiveness of the physical therapy treatments for LBP in children and adolescents.


Studies in English, Spanish, French, Italian and Portuguese, and carried out by March 2011, were selected by electronic and manual search. Two independent researchers coded the moderator variables of the studies, and performed the effect size calculations. The mean effect size index used was the standardized mean change between the pretest and posttest, and it was applied separately for each combination of outcome measures, (pain, disability, flexibility, endurance and mental health) and measurement type (self-reports, and clinician assessments).

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Since most manipulation is performed by chiropractors in this country, and most sports chiropractors employ active treatment regimens, children who are experiencing lower back pain should skip the pediatrician who has little training in this area and visit a chiropractor first. This is the most cost effective way since most children respond quite quickly, and those who require off the shelf shoe inserts for mechanical imbalances will have them recommended to them (you should never give a growing child a custom insole, they will outgrow it).