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Related Experiment Video

Updated: Jan 24, 2026

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Spinal manipulation for low-back pain.

P G Shekelle1, A H Adams, M R Chassin

  • 1RAND, Santa Monica, CA 90406-2138.

Annals of Internal Medicine
|October 1, 1992
PubMed
Summary
This summary is machine-generated.

Spinal manipulation offers short-term relief for acute low-back pain, especially uncomplicated cases. Evidence for chronic low-back pain efficacy remains insufficient.

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Area of Science:

  • Orthopedics and Musculoskeletal Medicine
  • Evidence-Based Medicine
  • Pain Management

Background:

  • Low-back pain is a prevalent condition with various treatment modalities.
  • Spinal manipulation is a frequently utilized therapy for low-back pain.
  • Understanding its efficacy and risks is crucial for clinical decision-making.

Purpose of the Study:

  • To comprehensively review the utilization, potential complications, and demonstrated efficacy of spinal manipulation in treating low-back pain.
  • To synthesize current evidence regarding spinal manipulation's effectiveness and safety profile.

Main Methods:

  • A systematic literature search was conducted using MEDLINE, supplemented by bibliography reviews and expert consultations.
  • Fifty-eight articles, including 25 controlled trials, were analyzed for data on use, complications, and efficacy.
  • A meta-analysis using the confidence profile method was performed on nine studies to quantify treatment effects on pain and function.

Main Results:

  • Spinal manipulation is predominantly provided by chiropractors in the United States.
  • While serious complications like paraplegia and death are reported, their incidence is likely low.
  • For acute, uncomplicated low-back pain, spinal manipulation showed a short-term recovery probability increase of 0.17 at 3 weeks.

Conclusions:

  • Spinal manipulation provides short-term benefits for certain patients, particularly those with acute, uncomplicated low-back pain.
  • Current data are inadequate to establish the efficacy of spinal manipulation for chronic low-back pain.
  • Further research is needed to clarify long-term outcomes and efficacy in chronic conditions.