- Neither spinal manipulation nor spinal mobilization are effective at reducing chronic low back pain (LBP).
Why this matters
- Although studies suggest that these manipulative therapies are effective at reducing subacute LBP, research on their efficacy in chronic LBP has produced mixed results.
- Randomized, placebo-controlled RELIEF trial.
- 162 people aged 18-45 years with chronic LBP received spinal manipulation (n=54), spinal mobilization (n=54), or sham cold laser therapy (placebo; n=54).
- Numerical Pain Rating Scale used for pain scores and Roland-Morris Disability Questionnaire used for disability score.
- Funding: NIH.
- Mean length of chronic pain was 6.2 years.
- No significant difference between groups in change in pain scores:
- Spinal manipulation vs spinal mobilization: 0.24 (P=.45).
- Spinal manipulation vs placebo: −0.03 (P=.92).
- Spinal mobilization vs placebo: −0.26 (P=.39).
- No significant difference between groups in change in disability scores:
- Spinal manipulation vs spinal mobilization: −1.00 (P=.14).
- Spinal manipulation vs placebo: −0.07 (P=.92).
- Spinal mobilization vs placebo: 0.93 (P=.17).
- Results may not apply to adults aged >45 years.