When a hemangioma is suspected, the challenge for the health care professional, is to be sure that it is in fact a hemangioma and not another type of tumor , particularly a malignant one. With specialized tests, however, doctors can reassure patients that the tumor is with little doubt a hemangioma. Such special testing may include scintigraphy (using a tiny amount of a radioactive substance to identify the hemangioma), CT scanning, or MRI ( magnetic resonance imaging ). In general, a biopsy of suspected hemangiomas is avoided because of their benign nature and the potential risk of bleeding from the biopsy.
In 2007 guidelines, the American College of Physicians and the American Pain Society included spinal manipulation as one of several treatment options for practitioners to consider when low-back pain does not improve with self-care. More recently, a 2010 Agency for Healthcare Research and Quality (AHRQ) report noted that complementary health therapies, including spinal manipulation, offer additional options to conventional treatments, which often have limited benefit in managing back and neck pain. The AHRQ analysis also found that spinal manipulation was more effective than placebo and as effective as medication in reducing low-back pain intensity. However, the researchers noted inconsistent results when they compared spinal manipulation with massage or physical therapy to reduce low-back pain intensity or disability.