Comparison of Effectiveness of Chiropractic Spinal Manipulation and Conservative Therapy for Low Back Pain

Author(s): Emmanuel Wong, Wai Ting Lee, Cherrie Chau, Hay Yeung Cheng, Ronald Kwok

The study is to describe the current evidence for the effectiveness of chiropractic spinal manipulation in comparison to the conservative intervention on Low Back Pain (LBP). The PubMed database was searched for randomised clinical trials of spinal manipulation and low back pain. Criteria for inclusion was subjects with low back pain treated with chiropractic spinal manipulation. Studies were excluded when participants were under the age of 18; conditions that were considered to be outside the discipline of manual therapy including systemic disease or malignancy, osteoporosis, pathological causes of LBP, LBP with radiculopathy; and contraindications to spinal manipulation. Data extraction included study design, number of participants, gestational age, spinal region, number of manipulations, manipulation technique details, profession of manipulator, active exercise reporting (Yes vs. No), type, and number of active exercises. Chiropractic care seems to be more effective than conservative intervention for LBP in reducing pain, increasing range of motion in lumbar spine, improving disability status, and enhancing general health. Furthermore, integrative care for LBP could be considered to improvise in the future treatment plan. The review of comparing different treatment approaches for LBP is still lacking and future research is needed to consider including a control group in order to provide accurate and persuasive outcomes.