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2016 ; 15
(3
): 165-83
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Spinal Manipulation Vs Sham Manipulation for Nonspecific Low Back Pain: A
Systematic Review and Meta-analysis
#MMPMID27660593
Ruddock JK
; Sallis H
; Ness A
; Perry RE
J Chiropr Med
2016[Sep]; 15
(3
): 165-83
PMID27660593
show ga
OBJECTIVE: The purpose of this systematic review was to identify and critically
evaluate randomized controlled trials of spinal manipulation (SM) vs sham
manipulation in the treatment of nonspecific low back pain. METHODS: Four
electronic databases were searched from their inception to March 2015 to identify
all relevant trials. Reference lists of retrieved articles were hand-searched.
All data were extracted by 2 independent reviewers, and risk of bias was assessed
using the Cochrane Back Review Group Risk of Bias tool. RESULTS: Nine randomized
controlled trials were included in the systematic review, and 4 were found to be
eligible for inclusion in a meta-analysis. Participants in the SM group had
improved symptoms compared with participants receiving sham treatment
(standardized mean difference = - 0.36; 95% confidence interval, - 0.59 to
- 0.12). The majority of studies were of low risk of bias; however, several of
the studies were small, the practitioner could not be blinded, and some studies
did not conduct intention-to-treat analysis and had a high level of dropouts.
CONCLUSION: There is some evidence that SM has specific treatment effects and is
more effective at reducing nonspecific low back pain when compared with an
effective sham intervention. However, given the small number of studies included
in this analysis, we should be cautious of making strong inferences based on
these results.
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