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WITHDRAWN: Spinal manipulative therapy for low-back pain.
Willem Jj Assendelft1, Sally C Morton, Emily I Yu
1Department of Public Health and Primary Care, Leiden University Medical Center, PO Box 9600, Leiden, Netherlands, 2300 RC.
The Cochrane Database of Systematic Reviews
|February 27, 2013
Summary
Spinal manipulative therapy (SMT) is not more effective than other standard treatments for low-back pain. This meta-analysis found no significant advantage of SMT over general practitioner care, analgesics, or physical therapy.
Area of Science:
- Orthopedics
- Pain Management
- Evidence-Based Medicine
Background:
- Low-back pain presents a significant health burden and economic cost.
- Spinal manipulative therapy (SMT) is a common recommendation for low-back pain.
- Previous reviews have yielded conflicting conclusions regarding SMT's effectiveness.
Purpose of the Study:
- To resolve discrepancies in SMT effectiveness for low-back pain.
- To compare SMT against various other treatments.
- To update effectiveness estimates using recent high-quality randomized controlled trials (RCTs).
Main Methods:
- Systematic search of multiple databases (Cochrane, MEDLINE, EMBASE, CINAHL) up to January 2000.
- Inclusion of 39 RCTs evaluating SMT for low-back pain with clinical outcome measures.
- Data extraction and classification of comparison treatments into seven categories.
Main Results:
- For acute low-back pain, SMT was superior only to sham or ineffective therapies.
- SMT showed no statistically or clinically significant advantage over general practitioner care, analgesics, physical therapy, exercises, or back school.
- Similar results were observed for chronic low-back pain; factors like pain radiation or study quality did not alter outcomes.
Conclusions:
- No evidence supports SMT being superior to other standard treatments for acute or chronic low-back pain.
- The findings suggest SMT should be considered comparable to conventional care options.
