Spinal Manipulation: Does It Help Neck and Back Pain?

Spinal Manipulation: Does It Help Neck and Back Pain?

Spinal Manipulation is a widely used tool to treat patients with neck and back pain, and for good reason. Evidence for the effectiveness of utilizing manipulation in certain subgroups of patients with spine pain is strong.  In 2004, one of the largest randomized controlled trials ever performed looked at whether spinal manipulation, spinal manipulation with exercise, or just exercise alone was best to treat patients with low back pain1.  The result suggested that not performing manipulation resulted in significantly worse outcomes.  The situation is similar in the neck.


This year a study was published comparing patients who received an exercise and stretching program versus patients who received the same program but also received two sessions of thoracic spine (upper back) manipulation2.  At the conclusion of the study 37.5% of patients in the exercise and stretching group were considered a success where as 81% of patients in the group that received manipulation were successes.


Overall the body of evidence to support spinal manipulation continues to build very rapidly. Next time you experience neck or back pain, ask your health care provider if spinal manipulation may help to more quickly and fully resolve your symptoms.


1. UK BEAM Trial Team. United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care. BMJ. 2004; Dec 11;329(7479):1381. Epub 2004 Nov 19

2. Cleland JA, Mintken PE, Carpenter K, Fritz JM, Glynn P, Whitman J, Childs JD. Examination of a clinical prediction rule to identify patients with neck pain likely to benefit from thoracic spine thrust manipulation and a general cervical range of motion exercise: multi-center randomized clinical trial. Phys Ther. 2010 Sep;90(9):1239-50. Epub 2010 Jul 15


Jeff Moore, DPT, MTC