I've been working with a physical therapist who specializes is mobilization and manual therapy techniques. The goal is to break the pain-spasm cycle that is causing my low back pain. It seems to help but it doesn't last. It feels as though if I could just relax enough during the session, we could really get somewhere with this treatment. Is there a pill or something I could take that would help?
You may be helped by a treatment referred to as medicine-assisted manipulation or MAM. The patient is sedated while the therapist performs more forceful stretches and joint mobilizations. For therapists trained in manual therapy, a high-velocity, short-amplitude thrust may be applied to the tight spinal segments. The patient's upper body and legs are held or stabilized to focus the motion at the spinal segment.
Manipulation under anesthesia may work because the patient's muscles are relaxed and not resisting the therapist's efforts to stretch muscles and/or joints. Sedation also makes it more likely that fibrous adhesions blocking motion can be released more effectively.
The therapist is able to stretch the hip and lumbrosacral joints in all planes of motion. Muscles that are holding or shortened cannot relax enough to be stretched. While under anesthesia, these muscles can be lengthened to a more normal position.
Using MAM requires a team approach. It usually involves an anesthesiologist, a trained manual therapist, and a nurse. The manual therapy team is often made up of a chiropractor or osteopath and a physical therapist. Communication among the various team members is important to a successful outcome.
You may want to check with your physician and/or your therapist to see if this treatment is possible in your area. If they do not perform MAM, then perhaps someone else is available to offer this service.
Simon Dagenais, DC, PhD, et al. Evidence-Informed Management of Chronic Low Back Pain with Medicine-Assisted Manipulation. In The Spine Journal. February 2008. Vol. 8. No. 1. Pp. 142-149.
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