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Spinal manipulative therapy for low back pain linked with ‘real, but small’ benefits for function, pain
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Researchers of this systematic review and meta-analysis found spinal manipulative therapy was linked with small improvements in pain and function for up to 6 weeks in patients with acute low back pain.
“On average, spinal manipulative therapy is associated with improvements in pain and function, but the size of the improvement is small,” Neil M. Paige, MD, MSHS, clinical professor of medicine in the David Geffen School of Medicine at UCLA, told Healio Rheumatology. “This makes it similar to NSAIDs, muscle relaxants and other acute back pain therapies.”
Using MEDLINE, Cochrane Database, EMBASE and Current Nursing and Allied Health Literature, Paige and colleagues performed a systematic literature review of spinal manipulative therapy (SMT) studies that measured pain and function and were published between 2011 and 2017.
Of the 26 randomized controlled trials found, 15 trials — with 1,711 patients total — had moderate-quality evidence that showed SMT had a significant association with improvement in pain. In addition, 12 trials — with 1,381 patients total — had moderate-quality evidence that showed SMT had a significant association with improvement in function. Minor transient adverse events — reported 50% to 67% of the time — included increased pain, headache and muscle stiffness.
“SMT is one of a number of treatments that have real, but small effects for acute low back pain,” Paige said. – by Will Offit
Disclosure: One researcher reports personal fees from ECRI Institute and UpToDate.
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