Restoring lumbar lordosis: a systematic review of controlled trials utilizing Chiropractic Bio Physics^® (CBP^®) non-surgical approach to increasing lumbar lordosis in the treatment of low back disorders

Abstract

[Purpose] To systematically review controlled trial evidence for the use of lumbar extension traction by Chiropractic BioPhysics ® methods for the purpose of increasing lumbar lordosis in those with hypolordosis and low back disorders. [Methods] Literature searches were performed in Pubmed, PEDro, CINAHL, Cochrane, and ICL databases. Search terms included iterations related to the lumbar spine, low back pain and extension traction rehabilitation. [Results] Four articles detailing 2 randomized and 1 non-randomized trial were located. Trials demonstrated increases in radiographic measured lordosis of 7–11°, over 10–12 weeks, after 30–36 treatment sessions. Randomized trials demonstrated traction treated groups mostly maintained lordosis correction, pain relief, and disability after 6-months follow-up. The non-randomized trial showed lordosis and pain intensity were maintained with periodic maintenance care for 1.5 years. Importantly, control/comparison groups had no increase in lumbar lordosis. Randomized trials showed comparison groups receiving physiotherapy-less the traction, had temporary pain reduction during treatment that regressed towards baseline levels as early as 3-months after treatment. [Conclusion] Limited but good quality evidence substantiates that the use of extension traction methods in rehabilitation programs definitively increases lumbar hypolordosis. Preliminarily, these studies indicate these methods provide longer-term relief to patients with low back disorders versus conventional rehabilitation approaches tested.

The reduction of high thoracic scoliosis in adults by mirror image^® blocking: a Chiropractic BioPhysics^® case series

“…In fact, as proven in clinical trials on adolescent idiopathic scoliosis patients 6 , 7 ) , ‘patient-specific’ customized exercise programs always outperform ‘conventional’ exercise programs that do not prescribe treatment that is specific to the spine deformity. This trend is also observed in the treatment of other spine deformities such as increasing cervical and lumbar hypolordosis, where customized rehabilitation treatment that is radiographically-guided results in better long-term patient outcomes 13 , 14 ) .…”

“…Typically, spinal X-rays are performed prior to and after a series of treatments to document spine alignment improvements. CBP methods have been shown to increase cervical 13 ) and lumbar lordosis 14 ) , reduce thoracic kyphosis 15 ) , reduce lateral thoracic 16 ) and head 17 ) translation postures as well as many other postural deformities (subluxations) 18 ) .…”

Radiophobic Fear-Mongering, Misappropriation of Medical References and Dismissing Relevant Data Forms the False Stance for Advocating Against the Use of Routine and Repeat Radiography in Chiropractic and Manual Therapy

“…However, patients having spine deformities exceeding these specific parameter thresholds have been documented to be treated by chiropractors (e.g. anterior sagittal balance >5 cm, 66 , 67 thoracic hyperkyphosis >60°, 68 - 70 pelvic tilt >25° indicating loss of lumbar lordosis, 71 - 75 scoliosis >20° 76 - 80 ). Indeed, the treatment of ASD patients who have significant disease burden often overlaps between spine surgeons and chiropractors/manual therapists.…”

“… 72 - 75 , 109 - 125 The spinopelvic parameters having the most accumulated evidence of non-surgical improvements (i.e. RCTs) include the treatment of forward head posture, 109 - 115 cervical hypolordosis/kyphosis, 110 - 117 thoracic hyperkyphosis (hunchback), 118 - 121 lumbar hypolordosis, 72 - 75 and scoliosis. 122 - 125 As can be seen, clinically significant magnitudes of corrections/improvements can be achieved in relatively short durations (e.g.…”

Smoke Screen to Distract From Flawed Science: A Response to Côté et al. Over Criticisms to Their Deficient ‘Rapid Review’ on Chiropractic X-Ray Utility

“…As we previously stated, 2 the inclusion of even one of these RCTs would have reversed their conclusions. Some of these excluded RCTs are summarized in recent systematic reviews, 4 , 5 and three more RCTs further showing the superiority of X-ray-guided treatment over tradition treatment approaches have also been published this year. 6 - 8 These RCTs can no longer be ignored and must be considered in any future discussion of X-ray utility in chiropractic and spine rehabilitation practice.…”