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July 9, 1960

Back Pain: Diagnosis and Treatment Using Manipulative Techniques

JAMA. 1960;173(10):1162. doi:10.1001/jama.1960.03020280102033

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Undergraduate or graduate physicians, particularly those who undergo training in orthopedics, have ample opportunity to learn operative techniques. The effective use of therapeutic exercises is also a part of the armamentarium, but these physicians receive little or no instruction in the manipulative treatment of back pain. Most are satisfied to leave this therapeutic tool in the hands of osteopaths, chiropractors, and others who are not fully accredited. On the other hand, even though they may question the theoretical concepts and the clinical diagnoses made by manipulative therapists, physicians are aware that many patients attest to the therapeutic benefit produced by such treatment. I have an uneasy feeling that physicians are ignoring a potentially useful therapeutic tool. The author states that "the method [manipulation] has been extremely useful in relieving symptoms arising from any part of the spine which are not caused by herniated discs or other gross pathological processes." He

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