Back pain and neck pain are among the most common symptoms prompting patients to seek care. Many treatments are used for back pain. Spinal manipulative therapy (SMT) is a treatment option available in VA. In order to better understand the potential role of SMT in treating acute back or neck pain, VA requested an up-to-date synthesis of the evidence.

Contents

• PREFACE
• EXECUTIVE SUMMARY
  • INTRODUCTION
  • METHODS
  • RESULTS
  • DISCUSSION
• INTRODUCTION
• METHODS
  • TOPIC DEVELOPMENT
  • SEARCH STRATEGY
  • STUDY SELECTION
  • DATA ABSTRACTION
  • QUALITY ASSESSMENT
  • DATA SYNTHESIS
  • RATING THE BODY OF EVIDENCE
  • PEER REVIEW
• RESULTS
  • LITERATURE FLOW
  • KEY QUESTION 1. What are the benefits and harms of spinal manipulation/chiropractic services for acute lower back pain (less than 6 weeks duration) compared to usual care or other forms of acute pain management?
  • KEY QUESTION 1A. What is the relationship between the use of spinal manipulation/chiropractic services for lower back pain and the use of opiate medication?
  • KEY QUESTION 2. What are the benefits and harms of spinal manipulation/chiropractic services for acute neck pain (less than 6 weeks duration) compared to usual care or other forms of acute pain management?
  • KEY QUESTION 2A. What is the relationship between the use of spinal manipulation/chiropractic services for acute neck pain and the use of opiate medication?
• SUMMARY AND DISCUSSION
  • SUMMARY OF EVIDENCE BY KEY QUESTION
  • LIMITATIONS
  • RESEARCH GAPS/FUTURE RESEARCH
• REFERENCES
• APPENDIX A. SEARCH STRATEGIES
• APPENDIX B. COCHRANE BACK GROUP RISK OF BIAS TOOL
• APPENDIX C. PEER REVIEW COMMENTS/AUTHOR RESPONSES
• APPENDIX D. EVIDENCE TABLE OF 26 RANDOMIZED CLINICAL TRIALS OF SPINAL MANIPULATIVE THERAPY FOR ACUTE LOW BACK PAIN

Suggested citation:

Shekelle PG, Paige NM, Miake-Lye IM, Beroes JM, Booth MS, Shanman R. The Effectiveness and Harms of Chiropractic Care for the Treatment of Acute Neck and Lower Back Pain: A Systematic Review. VA ESP Project #05-226; 2017.

This report is based on research conducted by the Evidence-based Synthesis Program (ESP) Center located at the West Los Angeles VA Medical Center, Los Angeles, CA, funded by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Quality Enhancement Research Initiative. The findings and conclusions in this document are those of the author(s) who are responsible for its contents; the findings and conclusions do not necessarily represent the views of the Department of Veterans Affairs or the United States government. Therefore, no statement in this article should be construed as an official position of the Department of Veterans Affairs. No investigators have any affiliations or financial involvement (eg, employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties) that conflict with material presented in the report.