Spinal adjustment for low back pain

Abstract

Spinal manual therapy, also known as spinal adjustment or manipulation, is widely recognized as a valid treatment option for low back pain. In the United States, 94 percent of spinal manipulation is delivered by chiropractors. In more than 40 controlled clinical trials on manipulation for low back pain, most have shown a benefit and none has shown manipulation to be inferior to a comparison treatment of a placebo. This led the Agency for Health Care Policy and Research to include spinal manipulation as one of only two recommended professional interventions for acute low back pain, while concluding that dozens of other conventional and alternative therapies lacked sufficient scientific documentation. There is also a growing body of evidence on the utilization of spinal manipulation for chronic low back pain. The effectiveness of manipulation and high rates of patient satisfaction with chiropractic care have led increasing numbers of primary care physicians to refer low back pain cases to chiropractors.