What is the role of spinal manipulation in the treatment of low back pain (LBP)?

Updated: Aug 22, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Another treatment with a long history of use for LBP is spinal manipulation, which analytically appears to be most beneficial for the treatment of acute axial spine pain without radiculopathy or neurological impairment. A recent systematic review concluded that there is good evidence for real improvement in cLBP after spinal manipulation when compared to sham or control interventions; however, this effect could not be determined to be more effective than other conservative therapies such as analgesics, exercise, or standard care. [275]

However, a Cochrane Review identified 26 randomized controlled trials (represented by 6070 participants) that assessed the effects of spinal manipulative therapy (SMT) in patients with cLBP; using high-quality evidence, the study concluded that SMT is no more effective than other commonly prescribed therapies for chronic low-back pain, such as exercise therapy, standard medical care, or physiotherapy. [276] In addition, no serious complications were observed.

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