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June 17, 1983

Study to evaluate manipulation therapy

JAMA. 1983;249(23):3148-3150. doi:10.1001/jama.1983.03330470006002

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This summer marks the start of what could be the largest scientific effort yet to prove or disprove the usefulness of manipulation for treating back pain. The technique predates Hippocrates but to this day remains entangled in confusion and controversy.

About 30 medical and osteopathic physicians and others researching manipulation will meet in Berne, Switzerland, Sept 11-17. Their goal: consensus on technique, on signs or symptoms that may call for or contraindicate manipulation, and even on terminology.

The very word "manipulation," for example, does not have the same meaning for each of its practitioners. The American Association of Colleges of Osteopathic Medicine's latest Glossary of Osteopathic Terminology (Educational Council on Osteopathic Principles, 23 June 1982) lists 19 definitions under this heading.

An abbreviated and general definition of manipulation might state that it involves various manual techniques of passive (the patient not actively participating) or active (patient moving in one direction