Spinal Manipulation Not Associated With Clinically Meaningful Benefits for LBP

HealthDay News – Spinal manipulative therapy was not associated with reduction of pain or fear of movement, increased quality of life, or improved isometric resistance of trunk flexors in patients with lower back pain (LBP) as compared to functional technique therapy, according to a study published in the The Spine Journal.

Adelaida María Castro-Sánchez, PT, PhD, from the University of Almeria in Spain, and colleagues compared the effective of spinal manipulation or functional technique (three once-weekly sessions) on pain, disability, kinesiophobia, and quality of life in 62 patients with chronic LBP.

The researchers found that patients receiving spinal manipulation experienced statistically, although not clinically, significant greater reductions in terms of disability. Over time, both groups showed significant improvement for the Roland-Morris Disability Questionnaire (both groups P < .001) and Oswestry Low Back Pain Disability Index (both groups P < .001). 

However, for pain intensity (P = .488), Tampa Scale of Kinesiophobia (P = .552), any domains of the Short Form-36 quality-of-life questionnaire (P ≤ .164), isometric resistance of abdominal muscles (P = .512), and finger-to-floor distance (P = .194), there were no significant treatment-by-time interactions.

Summary and Clinical Applicability

“As neither group met the threshold for minimum clinically important difference following treatment, neither treatment resulted in a clinically meaningful benefit,” the authors write.


Castro-Sánchez A, Lara-Palomo I, Matarán-Peñarrocha G et al. Short-term effectiveness of spinal manipulative therapy versus functional technique in patients with chronic nonspecific low back pain: a pragmatic randomized controlled trialSpine J. 2016;16(3):302-312. doi:10.1016/j.spinee.2015.08.057.