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:
- Common interventional procedures for chronic non-cancer spine pain: a systematic review and network meta-analysis of randomised trials. Wang 2025 BMJ.
- Gabapentinoids and Risk of Hip Fracture. Leung 2024 JAMA Netw Open.
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.
- Placebo analgesia in physical and psychological interventions: Systematic review and meta-analysis of three-armed trials. Hohenschurz-Schmidt 2024 Eur J Pain.