This site is intended for health professionals only

Spinal manipulation benefits limited

Spinal manipulation is no more effective than other interventions, such as physiotherapy or exercise, in treating acute low back pain, according to a new Cochrane review.

Pain at one month was 0.2 points lower on the visual analogue scale for spinal manipulation compared with other interventions, but this was not a clinically relevant effect.

Functional status at one week, as measured by a questionnaire, was a clinically irrelevant 0.07 points higher in the spinal manipulation participants than those who underwent other interventions. 

At one month, spinal manipulation was associated with a 0.1 point improvement in functional status, but again the effect was not clinically relevant.

The review looked at 16
randomised controlled trials with a total of 2,674 patients aged 18 or over. All had acute low back pain of less than six weeks’ duration.

The technique was also compared to a sham technique of non-targeted manipulation – and no significant difference in outcomes was seen. 

Study lead Dr Sidney Rubinstein, a senior researcher at the Institute for Health and Care Research at the University of Amsterdam, said: ‘No strong recommendations can be made for the use of spinal manipulation for acute low back pain.’

Cochrane 2012, online 12 September


Visit Pulse Reference for details on 140 symptoms, including easily searchable symptoms and categories, offering you a free platform to check symptoms and receive potential diagnoses during consultations.