The Journal of American Medical Association performed a systemic review of 26 RCT or randomized clinical trials and found the spinal manipulative treatment was statistically significant in improving acute low back pain for up to 6 weeks. This is also compared to sham treatments or other "alternative" treatments. Alternative in this case means "analgesics, muscle relaxants, exercises, physical therapy." The results were comparable to "analgesics, muscle relaxants, exercises, physical therapy" in efficacy and "modest." These studies did include "blind" studies which means that the experiment tried to eliminated experimenter or patient subject bias in removing labels while the experiment is performed. Key Points Question Is the use of spinal manipulative therapy in the management of acute (≤6 weeks) low back pain associated with improvements in pain or function? Findings
On April 4, 2017, the journal, Annals of Internal Medicine, a group of medical doctors, Amir Qaseem, MD, PhD, MHA; Timothy J. Wilt, MD, MPH; Robert M. McLean, MD; Mary Ann Forciea, MD, made a recommendation for the Clinical Guidelines Committee of the American College of Physicians regarding the treatment of low back pain which affects one quarter of the US. The committee gave three recommendations as guidelines for typical low back pain. Two of the strongest recommendations involved therapies including chiropractic. This is based on systematic review of the evidence in an established peer-review journal based on a community of medical doctors who specialize in internal medicine for the American College of Physicians. Target Audience and Patient Population: The target audience for this guideline includes all clinicians, and the target patient population includes adults with acute, subacute, or chronic low back pain. Recommendation 1: Given that most patients with acute or sub