Here are the findings of a Cochrane review.

First, the details.

  • 26 studies in 6070 participants were included.
  • 9 studies had a low risk of bias.
  • The primary outcomes were pain, functional status, and perceived recovery.
  • In addition, return-to-work and quality of life were included.

And, the results.

  • High quality evidence
    • Spinal manipulation has a small, statistically significant but not clinically relevant, short-term effect on pain relief compared to other treatment.
  • Varying levels of evidence (ranging from low to high)
    • Spinal manipulation has a significant short-term effect on pain relief and functional status when added to another treatment.
  • Very low quality evidence
    • Manipulation is not significantly more effective than inert interventions or sham manipulation for short-term pain relief or functional status.
  • Data are sparse for recovery, return-to-work, quality of life, and costs of care.
  • No serious complications were observed with spinal manipulation.

The bottom line?

The authors concluded, “High quality evidence suggests there’s no clinically relevant difference between spinal manipulation therapy and other interventions for reducing pain and improving function in patients with chronic low-back pain.”

The authors believe that determining cost-effectiveness of care should be a high priority for future research.

2/27/11 22:21 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.