What do systematic reviews say?

Spinal manipulative therapy vs other interventions

Spinal manipulative therapy probably leads to higher recovery at 1 month compared with all other interventions (moderate certainty).

• Spinal manipulative therapy for chronic low‐back pain 2011 · Cochrane Headline outcomes only
  RR 1.2 [1.04, 1.37]
  3 studies · 370 participants
  Moderate

Spinal manipulative therapy vs inert interventions

It is very uncertain whether spinal manipulative therapy changes recovery at 1 month compared with inert interventions (very low certainty).

• Spinal manipulative therapy for chronic low‐back pain 2011 · Cochrane Headline outcomes only
  RR 1.03 [0.49, 2.19]
  1 study · 72 participants
  Very low
• Spinal manipulative therapy for chronic low‐back pain 2011 · Cochrane Headline outcomes only
  RR 0.96 [0.56, 1.65]
  1 study · 70 participants
  Very low

Spinal manipulative therapy vs sham SMT

• Spinal manipulative therapy for acute low‐back pain 2012 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Spinal manipulative therapy vs other interventions

Spinal manipulative therapy showed no clear difference in recovery at one month compared with other interventions (low certainty).

• Spinal manipulative therapy for acute low‐back pain 2012 · Cochrane Headline outcomes only
  RR 1.06 [0.94, 1.21]
  2 studies · 117 participants
  Low

Spinal manipulative therapy plus another intervention vs the intervention alone

It is very uncertain whether spinal manipulative therapy plus another intervention changes recovery at 3 to 6 months compared with the intervention alone (very low certainty).

• Spinal manipulative therapy for acute low‐back pain 2012 · Cochrane Headline outcomes only
  RR 0.75 [0.51, 1.1]
  2 studies · 195 participants
  Very low

Spinal manipulative therapy plus another intervention vs the intervention alone

It is very uncertain whether spinal manipulative therapy plus any intervention changes recovery at one month compared with the intervention alone (very low certainty).

• Spinal manipulative therapy for chronic low‐back pain 2011 · Cochrane Headline outcomes only
  RR 3.4 [1.12, 10.28]
  1 study · 32 participants
  Very low