Spinal Manipulation and Chiropractic Research

Many studies have consistently reported beneficial responses to spinal manipulation, such as that performed by a doctor of chiropractic.

According to the Scientific Commission of the CCGPP:

  • Strong evidence supports spinal manipulation increasing function and reducing symptoms of acute and subacute lower back pain
  • Strong evidence supports spinal manipulation/mobilization reducing chronic back pain symptoms and improving function
  • Good evidence exists supporting exercise in conjunction with spinal manipulation to accelerate and improve outcomes and reduce the recurrence of episodes of back pain
  • Fair evidence supports spinal manipulation for lower back pain, radiating leg pain, sciatica or radiculopathy.1

See Chiropractic Treatments for Lower Back Pain

Spinal Manipulation Treatment Recommendations

The Agency for Health Care Policy and Research (AHCPR) recommends treating lower back pain with spinal manipulation:

  • In the first four weeks of symptoms
  • With or without non-prescription pain killers
  • In conjunction with mild exercise such as walking or swimming, followed by conditioning exercises after about two weeks.2

The AHCPR further stress the importance of resuming normal daily activities as quickly as possible and found that more than four days of bed rest can be counterproductive.


Spinal Manipulation Effectiveness vs. Other Treatments

The United Kingdom’s Clinical Standards Advisory Group CSAG advocates non-surgical care consisting of simple analgesics and physical therapy including chiropractic manipulation, active exercise, and physical activity.3

They specifically did not recommend inactivity or a policy of "wait and see" by stating:

"The main responsibility for preventing chronic low back pain and disability lies with the family doctor, occupational health service, physiotherapist, osteopathic physician, or chiropractor who is caring for the patient at this early stage. Early active rehabilitation is highly effective in preventing long term pain and disability."3

Other studies conducted by the RAND Corporation published for the first time that members of the medical community went on record stating that spinal manipulation is an appropriate treatment for certain conditions marked by symptoms of back pain.4


  • 1.Globe G, Morris C, Whalen W et al. Chiropractic Management of Low Back Disorders: Report from a Consensus Process. Journal of Manipulative and Physiological Therapeutics November/December 2008: 651-658.
  • 2.Bigos S, Bowyer O, Braen G et al (1994) Acute low back problems in adults. Clinical practice guideline No. 14. AHCPR Publication No. 95-0642, Rockville, MD; Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services.
  • 3.Rosen M Breen A et al. (1994). Management guidelines for back pain, Appendix B in Report of a clinical standards advisory group committee on back pain, Her Majesty’s Stationery Office (HMSO), London.
  • 4.Shekelle PG, Adams AH et al (1991). The appropriateness of spinal manipulation for low back pain: Indications and ratings by a multidisciplinary expert pane, RAND, Santa Monica, CA. Monograph No. R-4025/2 - CCR/FCER.