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The AHRQ review of spinal manipulation for chronic back pain: more bad news for chiropractors
Chronic back pain is often a difficult condition to treat. Which option is best suited? A review by the US 'Agency for Healthcare Research and Quality' (AHRQ) focused on non-invasive nonpharmacological treatments for chronic pain. The following therapies were considered: exercise, mind-body practices, psychological therapies, multidisciplinary rehabilitation, mindfulness practices, manual therapies, physical modalities, acupuncture. Here, I want to share with you the essence of the assessment of spinal manipulation: Spinal manipulation was associated with slightly greater effects than sham manipulation, usual care, an attention control, or a placebo intervention in short-term function (3 trials, pooled SMD -0.34, 95% CI -0.63 to -0.05, I2=61%) and intermediate-term function (3 trials, pooled SMD -0.40, 95% CI -0.69 to -0.11, I2=76%) (strength of evidence was low) There was no evidence of differences between spinal manipulation versus sham manipulation, usual care, an attention