Spinal manipulation offers limited advantages over other conservative back-pain care
A review found little to no meaningful pain difference versus other conservative treatments, with low or very low confidence across comparisons.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
For chronic low back pain, spinal manipulation may slightly improve function compared with other conservative care, while making little to no meaningful difference to pain. Larger improvements were reported against no treatment, and smaller pain improvements against sham treatment. Uncertain evidence and incomplete adverse-event reporting limit confidence in both benefits and harms.
Results varied substantially across trials, and fewer than half reported adverse events. This abstract-based account cannot establish reliable long-term benefits or confidently characterize uncommon harms.
What researchers found
Pain: mean difference on a 100-point scale
Spinal manipulation versus other conservative treatments at 1 month; 95% CI -8.26 to -1.17. Low-certainty evidence; little to no clinically important difference.
Why the comparison matters
The review separated sham treatment, no treatment and other conservative care. Those comparisons produced different estimates, so the apparent benefit cannot be described accurately without specifying what participants in the comparison group received.
What safety reporting showed
Reported adverse effects included soreness, stiffness and temporary increases in pain. The studies recorded no serious treatment-related complications, but reporting was incomplete and the reviewers judged the evidence about adverse effects very uncertain.
The original publication
Spinal manipulative therapy for adults with chronic low back pain.
de Zoete A, Innocenti T, Petrozzi MJ et al.
Cochrane Database Syst Rev · 2026
- PubMed ID
- 41494147
- Record checked
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