Is Spinal Manipulation Effective for Pain? An Overview of Systematic Reviews

Objective. This article is aimed at critically evaluating the evidence from systematic reviews (SRs) of spinal manipulation in patients with pain. Design. The study was designed as a SR of SRs. Methods. Four electronic databases were searched to identify all relevant articles of the effectiveness of spinal manipulation for pain. SRs were defined as articles employing a repeatable methods section. Results. Twenty-two SRs relating to the following pain conditions: low back pain (N = 6), headache (N = 5), neck pain (N = 4), any medical problem (N = 1), carpal tunnel syndrome (N = 1), dysmenorrhea (N = 1), fibromyalgia (N = 1), lateral epicondylitis (N = 1), musculoskeletal conditions (N = 1) and nonspinal pain (N = 1), were included. Positive or, for multiple SR, unanimously positive conclusions were drawn for none of the conditions mentioned earlier. Limitation. Publication bias as a well-known phenomenon may have been inherited in this article. Conclusion. Collectively, these data fail to demonstrate that spinal manipulation is an effective intervention for pain management.