- Spinal manipulative therapy (SMT) offered similar short-, intermediate-, and long-term pain relief and better short-term function than guideline-recommended therapies for chronic low back pain in adults.
Why this matters
- SMT is not recommended as a first-line treatment for chronic low back pain.
- Systematic review and meta-analysis evaluated 47 randomized controlled trials, involving 9211 participants, that examined the effect of SMT in middle-aged adults (age, 35-60 years) with chronic low back pain.
- Funding: None.
- Moderate-quality evidence suggested that SMT was similar to other recommended therapies for short-term pain relief at 1 (mean difference [MD], −3.17; 95% CI, −7.85 to 1.51) and 12 (MD, −1.86; 95% CI, −4.79 to 1.07) months.
- At 6 months, SMT resulted in statistically significant but not clinically better pain relief vs other recommended therapies (MD, −3.09; 95% CI, −5.42 to −0.77).
- SMT resulted in small but statistically better improvement in functional status at 1 month (standardized mean differences [SMD], −0.25; 95% CI, −0.41 to −0.09).
- The effect was not maintained at 6 months (SMD, −0.09; 95% CI, −0.21 to 0.03) and 12 (SMD, −0.09; 95% CI, −0.23 to 0.04) months.
- Limited number of included studies.
Coauthored with Antara Ghosh, PhD