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Chiropractors provide most of the manipulative therapy used in the United States for patients with low-back pain.Serious complications of lumbar manipulation,including paraplegia and death,have been reported.Although the occurrence rate of these complications is unknown,it is probably low. For patients with uncomplicated,acute low-back pain,the difference in probability of recovery at 3 weeks favoring treatment with spinal manipulation is 0.17(for example,increase in recovery from 50%to 67%;95% probability limits of estimate,0.07 to 0.28).For patients with low-back pain and sciatic nerve irritation,the difference in probabilities of recovery at 4 weeks is 0.098(probability limits,-0.016 to 0.209).Spinal manipulation is of short-term benefit in some patients,particularly those with uncomplicated,acute low-back pain.Data are insufficient concerning the efficacy of spinal manipulation for chronic low-back pain. |
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