Spinal manipulative therapy for low -back pain

Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence

“…Evidence base: Six Cochrane reviews [ 44 , 45 , 74 – 77 ], three guidelines [ 20 , 38 , 78 ], and 15 other systematic reviews [ 54 , 58 , 66 , 79 – 90 ] contributed to the evidence synthesis on the effect of manual therapy for the five most common musculoskeletal pain presentations. The effects of manual therapy on pain and function were mostly examined in combination with other treatments and mostly for non-acute pain.…”

“…Compared with other treatments (e.g. general practitioner care, acupuncture, ultrasound, standard physiotherapy, analgesic therapy, exercise, or back school), manual therapy appears to confer little or no clinically important effect on pain intensity, functional status, global improvement or return to work among patients with acute, subacute or chronic back pain with or without sciatica [ 74 – 77 , 92 , 93 ]. Type and experience of professional delivering the therapy did not show any clinically significant effect of on musculoskeletal pain [ 73 ].…”

Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence

“…Evidence base: Six Cochrane reviews [ 44 , 45 , 74 – 77 ], three guidelines [ 20 , 38 , 78 ], and 15 other systematic reviews [ 54 , 58 , 66 , 79 – 90 ] contributed to the evidence synthesis on the effect of manual therapy for the five most common musculoskeletal pain presentations. The effects of manual therapy on pain and function were mostly examined in combination with other treatments and mostly for non-acute pain.…”

“…Compared with other treatments (e.g. general practitioner care, acupuncture, ultrasound, standard physiotherapy, analgesic therapy, exercise, or back school), manual therapy appears to confer little or no clinically important effect on pain intensity, functional status, global improvement or return to work among patients with acute, subacute or chronic back pain with or without sciatica [ 74 – 77 , 92 , 93 ]. Type and experience of professional delivering the therapy did not show any clinically significant effect of on musculoskeletal pain [ 73 ].…”

A Systematic Review of Systematic Reviews of Spinal Manipulation

“…There was some overlap in relation to indications and the following conditions were included: back pain, neck pain, headache, any non-spinal pain, primary and secondary dysmenorrhoea, infantile colic, asthma, allergy, cervicogenic dizziness, any condition. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] The reviews tended to include either any type of SM or specifically focused on chiropractic SM. Five systematic reviews included more than 10 primary studies [7][8][9][10][11][12] and two had opted for a meta-analytical approach.…”

“…Five systematic reviews included more than 10 primary studies [7][8][9][10][11][12] and two had opted for a meta-analytical approach. 9,12 Generally speaking, the conclusions drawn from these systematic reviews were disappointing. The meta-analysis by Assendelft et al 9 suggested that SM was superior to sham therapy or to ineffective/harmful interventions for low back pain.…”

“…9,12 Generally speaking, the conclusions drawn from these systematic reviews were disappointing. The meta-analysis by Assendelft et al 9 suggested that SM was superior to sham therapy or to ineffective/harmful interventions for low back pain. The meta-analysis by Gross et al 12 implied that combining SM with other treatments, particularly exercise, is effective in reducing neck pain but demonstrated that SM is not effective as a singular treatment.…”

Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence

“…Evidence base: Six Cochrane reviews [ 44 , 45 , 74 – 77 ], three guidelines [ 20 , 38 , 78 ], and 15 other systematic reviews [ 54 , 58 , 66 , 79 – 90 ] contributed to the evidence synthesis on the effect of manual therapy for the five most common musculoskeletal pain presentations. The effects of manual therapy on pain and function were mostly examined in combination with other treatments and mostly for non-acute pain.…”

“…Compared with other treatments (e.g. general practitioner care, acupuncture, ultrasound, standard physiotherapy, analgesic therapy, exercise, or back school), manual therapy appears to confer little or no clinically important effect on pain intensity, functional status, global improvement or return to work among patients with acute, subacute or chronic back pain with or without sciatica [ 74 – 77 , 92 , 93 ]. Type and experience of professional delivering the therapy did not show any clinically significant effect of on musculoskeletal pain [ 73 ].…”

A Systematic Review of Systematic Reviews of Spinal Manipulation

“…There was some overlap in relation to indications and the following conditions were included: back pain, neck pain, headache, any non-spinal pain, primary and secondary dysmenorrhoea, infantile colic, asthma, allergy, cervicogenic dizziness, any condition. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] The reviews tended to include either any type of SM or specifically focused on chiropractic SM. Five systematic reviews included more than 10 primary studies [7][8][9][10][11][12] and two had opted for a meta-analytical approach.…”

“…Five systematic reviews included more than 10 primary studies [7][8][9][10][11][12] and two had opted for a meta-analytical approach. 9,12 Generally speaking, the conclusions drawn from these systematic reviews were disappointing. The meta-analysis by Assendelft et al 9 suggested that SM was superior to sham therapy or to ineffective/harmful interventions for low back pain.…”

“…9,12 Generally speaking, the conclusions drawn from these systematic reviews were disappointing. The meta-analysis by Assendelft et al 9 suggested that SM was superior to sham therapy or to ineffective/harmful interventions for low back pain. The meta-analysis by Gross et al 12 implied that combining SM with other treatments, particularly exercise, is effective in reducing neck pain but demonstrated that SM is not effective as a singular treatment.…”

Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence

“…Evidence base: Six Cochrane reviews [ 44 , 45 , 74 – 77 ], three guidelines [ 20 , 38 , 78 ], and 15 other systematic reviews [ 54 , 58 , 66 , 79 – 90 ] contributed to the evidence synthesis on the effect of manual therapy for the five most common musculoskeletal pain presentations. The effects of manual therapy on pain and function were mostly examined in combination with other treatments and mostly for non-acute pain.…”

“…Compared with other treatments (e.g. general practitioner care, acupuncture, ultrasound, standard physiotherapy, analgesic therapy, exercise, or back school), manual therapy appears to confer little or no clinically important effect on pain intensity, functional status, global improvement or return to work among patients with acute, subacute or chronic back pain with or without sciatica [ 74 – 77 , 92 , 93 ]. Type and experience of professional delivering the therapy did not show any clinically significant effect of on musculoskeletal pain [ 73 ].…”

A Systematic Review of Systematic Reviews of Spinal Manipulation

“…There was some overlap in relation to indications and the following conditions were included: back pain, neck pain, headache, any non-spinal pain, primary and secondary dysmenorrhoea, infantile colic, asthma, allergy, cervicogenic dizziness, any condition. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] The reviews tended to include either any type of SM or specifically focused on chiropractic SM. Five systematic reviews included more than 10 primary studies [7][8][9][10][11][12] and two had opted for a meta-analytical approach.…”

“…Five systematic reviews included more than 10 primary studies [7][8][9][10][11][12] and two had opted for a meta-analytical approach. 9,12 Generally speaking, the conclusions drawn from these systematic reviews were disappointing. The meta-analysis by Assendelft et al 9 suggested that SM was superior to sham therapy or to ineffective/harmful interventions for low back pain.…”

“…9,12 Generally speaking, the conclusions drawn from these systematic reviews were disappointing. The meta-analysis by Assendelft et al 9 suggested that SM was superior to sham therapy or to ineffective/harmful interventions for low back pain. The meta-analysis by Gross et al 12 implied that combining SM with other treatments, particularly exercise, is effective in reducing neck pain but demonstrated that SM is not effective as a singular treatment.…”