Developing manipulative skills in physiotherapists

Within a market environment, managers and therapists are under growing pressure to provide evidence-based services. No more acutely has this been seen than in the management of low back pain. The Clinical Standard Advisory Group report (1994) and the Clinical Guidelines for the Management of Acute Low Back Pain (Department of Health, 1996) have produced nationwide responses within physiotherapy and other professions involved in its management. Within these reports the use of manipulation in patients with acute low back pain is advocated.