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Manipulative therapies, including spinal manipulation, offer short-term pain relief for back and neck pain comparable to standard treatments. While potentially effective for migraines, evidence for other childhood conditions is limited, and rare serious adverse events warrant caution.

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Area of Science:

  • Integrative Medicine
  • Manual Therapies
  • Evidence-Based Practice

Background:

  • Manipulative therapies encompass a range of manual techniques used for various adult and pediatric conditions.
  • Spinal manipulative therapy shows short-term efficacy for low back pain and cervical manipulation for neck pain.
  • Current evidence supports manipulative therapies for specific conditions like migraine headaches and reducing hospital stays in preterm infants.

Purpose of the Study:

  • To review the evidence supporting the efficacy and safety of manipulative therapies for a range of conditions.
  • To assess the comparative effectiveness of manipulative therapies against conventional treatments.
  • To identify the risks and benefits associated with manipulative therapies.

Main Methods:

  • Systematic review of existing literature on manipulative therapies.
  • Comparative analysis of outcomes between manipulative therapies and other treatments.
  • Evaluation of reported adverse events, both mild and serious.

Main Results:

  • Spinal manipulative therapy offers short-term benefits for low back pain, comparable to standard care.
  • Cervical manipulation provides superior short-term pain relief and functional improvement for neck pain versus oral analgesics.
  • Manipulative therapies demonstrate comparable efficacy to amitriptyline for migraine treatment, reducing pain frequency and intensity.

Conclusions:

  • Manipulative therapies show promise for specific conditions like low back pain, neck pain, and migraines.
  • Evidence for efficacy in pediatric conditions is largely lacking, except for preterm infants.
  • While generally safe with mild side effects, rare serious adverse events necessitate further high-quality research before widespread recommendations.