Underwhelming: spinal adjustment and massage for back pain, neck pain
One page on PainSci cites Bronfort 2010: Does Spinal Manipulation Work?
PainSci notes on Bronfort 2010:
This review of manual therapies focusses on spinal manipulative therapy and massage therapy for low back and neck pain, with predictably mixed results ranging from inconclusive to underwhelming to suspiciously positive. Both are judged “effective” for some conditions but not impressively so, and mostly no different from other therapies that are notoriously unimpressive. For instance, the authors write that SMT is effective but “similar in effect to other commonly used efficacious therapies such as usual care, exercise, or back school.” How nice for SMT that it can hold its own against “back school.”
The “effective” conclusions about SMT for various conditions seems strange to me, because the actual data is consistent with the much more negative conclusions of other major reviews, most Rubinstein et al. I suspect these authors are keen to say nice things about SMT.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions.
related content
- “Spinal manipulative therapy for acute low-back pain,” Rubinstein et al, Cochrane Database of Systematic Reviews, 2012.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Long-Term Effects of Repeated Injections of Local Anesthetic With or Without Corticosteroid for Lumbar Spinal Stenosis: A Randomized Trial. Friedly 2017 Arch Phys Med Rehabil.
- Cannabis-based medicines for chronic neuropathic pain in adults. Ateş 2026 Cochrane Database Syst Rev.
- Effect of exercise on depression and anxiety symptoms: systematic umbrella review with meta-meta-analysis. Munro 2026 Br J Sports Med.
- Optimizing elastic band resistance training for Metabolic Syndrome components in older adults: A systematic review, meta-analysis, and meta-regression of randomized controlled trials. Saez-Berlanga 2026 Arch Phys Med Rehabil.
- Biomechanical insights into Achilles tendinopathy risk and protection in runners: a large prospective study 4HAIE. Jandacka 2026 Br J Sports Med.