Disc Herniation: Opinion and Practice of OsteopathsWhat are the opinions and practices of osteopathic doctors about the treatment of disc problems? Do they use the common straight leg raise (SLR) test to diagnose disc herniation? Does the result of the SLR figure into their treatment decisions?
These questions were asked in this study. A survey was sent to all the registered osteopaths in the United Kingdom (a total of 1,030). About half the osteopaths returned the survey.
Everyone agreed about when and how to use the SLR test. Half the group said they use spinal manipulation for disc herniation. They said that putting a force on the spinal joint restores motion in the spine. The other half thinks this treatment is dangerous.
There's a lot of debate and not much agreement on this point. Some say spinal motion can damage the disc. An already injured disc could be harmed even more during a manipulation. Others think manipulating a nearby segment is helpful and can be done without shocking the damaged disc.
The authors report common and correct use of the SLR test by osteopaths. Use of spinal manipulation for disc herniation isn't so clear. They suggest another study to look at whether or not spinal manipulation should be done for lumbar disc herniation.
Richard Rebain, BSc(Econ), BSc(Ost), DO, et al. The Passive Straight Leg Raising Test in the Diagnosis and Treatment of Lumbar Disc Herniation: A Survey of United Kingdom Osteopathic Opinion and Clinical Practice. In Spine. August 1, 2003. Vol. 28. No. 15. Pp. 1717-1724.
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