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Spinal Manipulation for Low Back Pain


According to a new article by, spinal manipulation for lower back pain are comparable to NSAIDs

"Spinal manipulation therapy was shown to have modest improvements on pain and function at up to six weeks in patients with acute low back pain (LBP), according to a study published in JAMA (2017;317:1451-1460). 

Moreover, the therapy was associated with only “temporary minor musculoskeletal harms,” according to the researchers.

Paul G. Shekelle, MD, PhD, of the VA West Los Angeles Medical Center, and his colleagues conducted a review and meta-analysis of previous studies to assess the efficacy and safety of spinal manipulation compared with other nonmanipulative therapies for adults with acute LBP (six weeks or less).

After analyzing 26 eligible randomized clinical trials (RCTs), the researchers found 15 trials (n=1,711) provided moderate evidence that spinal manipulation showed statistically significant improvements in pain. Twelve RCTs (n=1,381) demonstrated moderate evidence that spinal manipulation was significantly linked to improvements in function. No RCTs reported any serious adverse events. Minor, transient adverse events—increased pain, muscle stiffness and headache—were reported in 50% to 67% of cases. Differences in study results were not explained by type of clinician performing spinal manipulation, type of manipulation, study quality or whether spinal manipulation was given alone or as part of a package of therapies.

The authors wrote that the benefits of spinal manipulation for acute LBP were comparable to those seen with nonsteroidal anti-inflammatory drugs, according to the Cochrane review on this topic.

Back pain is among the most common symptoms prompting patients to seek care, with 50% of the population experiencing it at some point in their lifetime. Available treatments for acute LBP include analgesics, muscle relaxants, exercise, physical therapy, heat and spinal manipulative therapy."


- Based on a press release from JAMA

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