Spinal Manipulation

Cox® Technic Flexion Distraction and Decompression is spinal manipulation. It is chiropractic adjusting. Doctors generally code it as a 98940-series for insurance. The American Chiropractic Association describes flexion distraction as spinal manipulation. (See the Members Area on Coding and Reimbursement.)
Why spinal manipulation? Spinal manipulation is the manual movement of the spinal vertebrae to restore normal range of motion, relieve nerve compression and irritation, relieve pain, and restore a state of well-being to the patient. Cox® Technic Flexion Distraction does just that.
In the lumbar spine, Cox® Technic
  1. Increases the disc space height 17%
  2. Increases the nerve opening sizes in the spine through which spinal nerves pass from the spinal cord to the body by up to 28% in area
  3. Intradiscal pressure reduction which reduces nerve irritation inside the disc and reduces nerve pressure on exiting nerves from the spine that cause arm and leg pain. This drop in pressure has been measured as high as 192 mm reduced pressure inside the intervertebral disc.
  4. Restores normal range of motion to the joints of the spine
  5. Establishes nerve conduction from the extremities, spinal joints and intervertebral discs to the spinal cord and brain that have a sedating and pain relieving capability. (afferentation)
In the cervical spine, Cox® Technic
  1. Lowers C4-C7 intradiscal pressures as much as 96 to 1583 mmHG pressure depending on the level. 
  2. Provides relief satisfaction for patients 
  3. Restores normal range of motion to the joints of the spine
  4. Establishes nerve conduction from the extremities, spinal joints and intervertebral discs to the spinal cord and brain that have a sedating and pain relieving capability. (afferentation)
A Cry in the Medical Literature for Spinal Manipulation
"I'm a chiropractor..." What does the other person say in reply? Something like "Oh doc, I have back pain..."?  Chiropractic and back pain seem to go hand-in-hand. And spinal manipulation for back pain relief is effective.
Researchers and authors call for spinal manipulation as conservative care for lower back pain relief and other spinal conditions's relief. Here is a sampling of published articles calling for spinal manipulation, directly or indirectly: 
  • Spinal manipulation is recommended by the American Pain Society and the American College of Physicians for primary care of low back pain. (Chou)
  • Back schools (for short-term improvement), and short courses of manipulation/mobilization can also be considered. The use of physical therapies (heat/cold, traction, laser, ultrasound, short wave, interferential, massage, corsets) cannot be recommended. We do not recommend TENS. (Airaksinen)
  • 5 to 10 sessions of spinal manipulative therapy administered over 2 to 4 weeks achieve equivalent or superior improvement in pain and function when compared with other commonly used interventions, such as physical modalities, medication, education, or exercise, for short, intermediate, and long-term follow-up. (Dagenais)
  • Spinal manipulation is safe and recommended for acute low back pain. (Bigos)
  • Canadian Spine Surgeons Want Spine Surgery Candidates, Not Back Pain Sufferers 
  • Canadians wait years for spinal surgeons appointments which they don't need. MRIs show spinal abnormalities that make family doctors refer unnecessarily. Lots of money is spent on unnecessary tests and doctor visits. Canada tries to set up a better system to train family doctors to better know who needs surgery and who doesn't.  (Priest)
  • Life Threatening Complications and Costs Increase with Increased Rate of Complex Fusion Procedures (Deyo)
  • Disability after Fusion Is High, Fusion Rates Increase (Juratli)
  • Chiropractic patient back pain care less expensive than medical doctor care. (NC study) (Phelan)
  • Chiropractic patient back pain care initiated with a DC cost  40% less than care started with a MD.  (TN study) (Liliedahl)
  • NEW - American College of Physicians recommend spinal manipulation is appropriate as first line care of acute, subacute and chronic low back pain. (Qaseem)
  • In the JAMA, a review reports that spinal manipulation for acute low back pain provides beneficial moderate relief with minor musculoskeletal side effects.  (Paige
  • NEW - Chiropractic spinal manipulation is popular today with more clinical trials being produced as well as guidelines recommending its use for back pain. (Deyo editorial
Spinal manipulation has a place in spine pain relief. Spinal manipulation is non-surgical, non-invasive, effective, and less costly. Chiropractic is at the forefront of spinal manipulation delivery, with nearly 94% of spinal manipulation being delivered by chiropractors (though other healthcare providers are encroaching as its effectiveness is documented). Cox® Technic physicians are poised to be successful in back pain relief with this flavor of spinal manipulation.
Visit our research page to learn more about the documentation of Cox® Technic spinal manipulation. Then, plan to join a webinar soon to hear more of these statistics and new ones or a seminar to learn more about incorporating Cox® Technic into your practice.