Seeking Early Treatment for Back Pain Yields Best Results

Austin-based Spine Experts at Texas Physical Therapy Specialists Explain why Seeking Early Treatment for Back Pain Yields Best Results

(Austin, TX – July 29, 2010)

Recent studies by TexPTS and leading medical journals have shown that patients with back pain who receive thrust spinal manipulation by their physical therapist and therapist-guided exercises need less medicine, less health care, and miss less work. “I saw results quickly and felt a big difference in my pain level. I am even off of my pain prescription drug…. I will always remember when Chris performed his magical manual therapy…” said recent patients at TexPTS, theAustin-based spine experts. Is it magic? Or can Texas Physical Therapy Specialists (TexPTS) physical therapists predict which patients with back pain are best suited for spinal manipulation as treatment?

Dr. John Childs, PT, PhD, is a physical therapist at TexPTS and a professor in the US Army-Baylor University. He is the lead author of research that was published in the December 2004 issue of Annals of Internal Medicine.    Dr. Childs and his associates noticed that not all patients with back pain got better after spinal manipulation. Their research produced a ‘prediction rule’ which reveals factors in patients with back pain that predict if they would or wouldn’t get better.

Patients were divided into two groups. The first group received ‘high-velocity thrust spinal manipulation’ by their physical therapist plus therapist-guided exercises. The second group got only exercises. Each group saw their physical therapist five (5) times. Six months later the patients that got both manipulation and therapist-guided exercises needed less medicine, less health care, and had missed less work.

For medical research to be regarded as best practice, it has to be repeated in different places. Since the 2004 study, this prediction rule for using manipulation with back pain has been confirmed in three other medical journals.* More research found that patients who did not receive thrust manipulation were 8 times more likely for back pain to worsen. The prediction rule found that two important factors for success. One was back pain less than 16 days old. The other is the pain does not extend below the knee.

According to David Browder, DPT, OCS, a physical therapist in Austin, TX at TexPTS, “The study found that if the pain was less than 16 days old and did not extend below the knee, 9 out of 10 patients reduced their back pain by 50% after one manipulation. I have found this to be case with my patients. In my practice, these same patients reduce their pain by 72% after only 4 visits.” The success of this treatment has also caused the development of prediction rules for when to manipulate the upper back in patients who complain of neck pain as well.

For patients that receive spinal manipulation, the question always arises about the ‘pop’. This often noisy ‘pop’ is thought to be due to the presence of nitrogen bubbles in the joint that burst when the joint is stretched. An interesting finding published in the January 2006 issue of Journal of Manipulative and Physiological Therapeutics by Dr. Childs suggests that pain was lessened whether patients with back pain experienced a ‘pop’ during thrust spinal manipulation or not.

*These include the July 2005 issue of the BMC Family Practice, the April 2006 issue of the Journal of Orthopedic and Sports Physical Therapy as well as the November 2006 issue of Manual Therapy.

About Texas Physical Therapy Specialists:
Texas Physical Therapy Specialists (TexPTS) is a private physical therapy practice with locations throughout San Antonio, Austin, and Tyler. Known for teaching and training physical therapists all over the US, TexPTS physical therapists pride themselves in being spine experts. They deliver hands-on physical therapy based on the newest research to achieve the best results for patients with bad backs, achy joints, wounded hands, and work injuries. Along the way, the TexPTS family has fun and makes friends with their patients (and their pets, their kids, their in-laws, and neighbors….) Perhaps this is why they were voted the Best Private Physical Therapy Practice in the U.S. in 2009 by their peers in the American Physical Therapy Association. For more information visit our website at or find us on Facebook.


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