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Spinal manipulation ‘has benefits for back pain and migraine’

By Mark Pownall

Spinal manipulation techniques such as osteopathy, chiropractic, massage and physiotherapy are effective in treating acute and chronic low back pain, migraine and some headaches, a review concludes.

The review, commissioned by the General Chiropractic Council and conducted by US and Canadian researchers, also supported use of manipulation in hip and knee osteoarthritis and plantar fasciitis.

But it found spinal manipulation was ineffective in asthma, hypertension, pneumonia, dysmenorrhoea and childhood colic, and that there was an absence of evidence in otitis media and enuresis in children.

Evidence spinal manipulation was effective for sciatica, coccydynia, mid back pain and neck pain, or that manual therapies were effective in fibromyalgia, was inconclusive.

Professor Martin Underwood, professor of primary care at the University of Warwick whose commentary was published alongside the research in Chiropractic & Osteopathy, said: ‘There is evidence to support use of manual therapies for a range of primarily musculoskeletal disorders for which it is biologically plausible.'

But he said there was no evidence for their use for other disorders where an effect did not seem biologically plausible.

The research concluded manipulation therapies had a low risk of adverse events, listing mild and transient pain and discomfort and nausea, dizziness and tiredness as more common side effects.

Vertebrobasilar artery stroke is a serious adverse event occurring in between one in 200,000 and one in several million treatments, the review said.

Its publication came as science writer Dr Simon Singh won a court case allowing him to defend criticism of chiropractic as ‘fair comment'.

Spinal manipulation has benefits for back pain and migraine, says a new study


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