Aetna was informed that the U.S. Agency for Health Care Policy and Research in 1994 published its Acute Low Back Problems in Adults: Clinical Practice Guidelines. Under the rubric of "physical treatments," the multidisciplinary panel's only recommendation was spinal manipulation. Specifically, the panel said: "Manipulation can be helpful for patients with acute low back problems without radiculopathy when used within the first month of symptoms."
Aetna has since reissued its low back pain guidelines with the following statement: "A short course of physical therapy or other spine therapy, such as spinal manipulation or massage, may be beneficial."
"Not a rousing endorsement of manipulation," said a spokesperson from the Ohio State Chiropractic Association, "but it is a step in the right direction when a major insurance company changes its discriminatory practices and adheres to the research literature that has demonstrated manipulation's effectiveness for the treatment of back pain."
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