Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis

Ian D Coulter, Cindy Crawford, Eric L Hurwitz, Howard Vernon, Raheleh Khorsan, Marika Suttorp Booth, Patricia M Herman, Ian D Coulter, Cindy Crawford, Eric L Hurwitz, Howard Vernon, Raheleh Khorsan, Marika Suttorp Booth, Patricia M Herman

Abstract

Background context: Mobilization and manipulation therapies are widely used to benefit patients with chronic low back pain. However, questions remain about their efficacy, dosing, safety, and how these approaches compare with other therapies.

Purpose: The present study aims to determine the efficacy, effectiveness, and safety of various mobilization and manipulation therapies for treatment of chronic low back pain.

Study design/setting: This is a systematic literature review and meta-analysis.

Outcome measures: The present study measures self-reported pain, function, health-related quality of life, and adverse events.

Methods: We identified studies by searching multiple electronic databases from January 2000 to March 2017, examining reference lists, and communicating with experts. We selected randomized controlled trials comparing manipulation or mobilization therapies with sham, no treatment, other active therapies, and multimodal therapeutic approaches. We assessed risk of bias using Scottish Intercollegiate Guidelines Network criteria. Where possible, we pooled data using random-effects meta-analysis. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was applied to determine the confidence in effect estimates. This project is funded by the National Center for Complementary and Integrative Health under Award Number U19AT007912.

Results: Fifty-one trials were included in the systematic review. Nine trials (1,176 patients) provided sufficient data and were judged similar enough to be pooled for meta-analysis. The standardized mean difference for a reduction of pain was SMD=-0.28, 95% confidence interval (CI) -0.47 to -0.09, p=.004; I2=57% after treatment; within seven trials (923 patients), the reduction in disability was SMD=-0.33, 95% CI -0.63 to -0.03, p=.03; I2=78% for manipulation or mobilization compared with other active therapies. Subgroup analyses showed that manipulation significantly reduced pain and disability, compared with other active comparators including exercise and physical therapy (SMD=-0.43, 95% CI -0.86 to 0.00; p=.05, I2=79%; SMD=-0.86, 95% CI -1.27 to -0.45; p<.0001, I2=46%). Mobilization interventions, compared with other active comparators including exercise regimens, significantly reduced pain (SMD=-0.20, 95% CI -0.35 to -0.04; p=.01; I2=0%) but not disability (SMD=-0.10, 95% CI -0.28 to 0.07; p=.25; I2=21%). Studies comparing manipulation or mobilization with sham or no treatment were too few or too heterogeneous to allow for pooling as were studies examining relationships between dose and outcomes. Few studies assessed health-related quality of life. Twenty-six of 51 trials were multimodal studies and narratively described.

Conclusion: There is moderate-quality evidence that manipulation and mobilization are likely to reduce pain and improve function for patients with chronic low back pain; manipulation appears to produce a larger effect than mobilization. Both therapies appear safe. Multimodal programs may be a promising option.

Keywords: Chiropractic; Chronic low back pain; Manipulation; Meta-analysis; Mobilization; Systematic review.

Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Figures

Fig. 1
Fig. 1
Search strategy. Note: Figure 1 addresses search strategy for low back pain as well as neck pain studies. The findings of neck pain studies are not reported here. Because the Center of Excellence for Research in CAM (CERC) project was focused on both chronic neck pain as well as chronic low back pain, the search was executed to meet both needs together to streamline the effort.
Fig. 2
Fig. 2
Flow of included studies. CCT, controlled clinical trial; CLBP, chronic low back pain; OBS, observational studies; RCT, randomized controlled trial.
Fig. 3
Fig. 3
Reduction in pain.
Fig. 4
Fig. 4
Reduction in disability.

References

    1. Wise J. Spinal manipulation produces modest improvements in acute low back pain. BMJ. 2017;357:j1843.
    1. Paige N, Miake-Lye I, Booth MI, et al. Association of spinal manipulative therapy with clinical benefit and harm for acute low back pain: systematic review and meta-analysis. JAMA. 2017;317:1451–60.
    1. Dowell D, Haegerich T, Chou R. DC guideline for prescribing opioids for chronic pain—495 united states, 2016. JAMA. 2016;315:1624–45.
    1. Balague F, Mannion AF, Pellise F, Cedraschi C. Non-specific low back pain. Lancet. 2012;379:482–91.
    1. Itz CJ, Geurts JW, van Kleef M, Nelemans P. Clinical course of non-specific low back pain: a systematic review of prospective cohort studies set in primary care. Eur J Pain. 2013;17:5–15.
    1. Office of the Army Surgeon General, Pain Management Task Force. Pain Management Task Force Final Report: providing a standardized DoD and VHA vision and approach to pain management to optimize the care for warriors and their families. Washington, DC: Office of the Army Surgeon General; 2010.
    1. Salzberg LD, Manusov EG. Management options for patients with chronic back pain without an etiology. Health Serv Insights. 2013;6:33–8.
    1. Deyo RA, Mirza SK, Turner JA, Martin BI. Overtreating chronic back pain: time to back off? J Am Board Fam Med. 2009;22:62–8.
    1. Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147:478–91.
    1. Kizhakkeveettil A, Rose K, Kadar GE. Integrative therapies for low back pain that include complementary and alternative medicine care: a systematic review. Glob Adv Health Med. 2014;3:49–64.
    1. Furlan AD, Yazdi F, Tsertsvadze A, et al. Complementary and alternative therapies for back pain II. Evid Rep Technol Assess (Full Rep) 2010:1–764.
    1. Santaguida PL, Gross A, Busse J, et al. Complementary and alternative medicine in back pain utilization report. Evid Rep Technol Assess (Full Rep) 2009;177:1–221.
    1. Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine J. 2004;4:335–56.
    1. Gross A, Miller J, D’Sylva J, et al. Manipulation or mobilisation for neck pain: a Cochrane Review. Man Ther. 2010;15:315–33.
    1. Schroeder J, Kaplan L, Fischer DJ, Skelly AC. The outcomes of manipulation or mobilization therapy compared with physical therapy or exercise for neck pain: a systematic review. Evid Based Spine Care J. 2013;4:30–41.
    1. Furlan AD, Clarke J, Esmail R, Sinclair S, Irvin E, Bombardier C. A critical review of reviews on the treatment of chronic low back pain. Spine. 2001;26:E155–62.
    1. Assendelft WJ, Morton SC, Yu EI, Suttorp MJ, Shekelle PG. Spinal manipulative therapy for low back pain. A meta-analysis of effectiveness relative to other therapies. Ann Intern Med. 2003;138:871–81.
    1. Shekelle PG, Adams AH, Chassin MR, Hurwitz EL, Brook RH. Spinal manipulation for low-back pain. Ann Intern Med. 1992;117:590–8.
    1. Furlan AD, Yazdi F, Tsertsvadze A, et al. A systematic review and meta-analysis of efficacy, cost-effectiveness, and safety of selected complementary and alternative medicine for neck and low-back pain. Evid Based Complement Alternat Med. 2012;2012:953139.
    1. Shekelle PG, Hurwitz EL, Coulter I, Adams AH, Genovese B, Brook RH. The appropriateness of chiropractic spinal manipulation for low back pain: a pilot study. J Manipulative Physiol Ther. 1995;18:265–70.
    1. Shekelle PG, Coulter I. Cervical spine manipulation: summary report of a systematic review of the literature and a multidisciplinary expert panel. J Spinal Disord. 1997;10:223–8.
    1. Deyo RA, Dworkin SF, Amtmann D, et al. Report of the NIH task force on research standards for chronic low back pain. J Pain. 2014;15:569–85.
    1. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389:736–47.
    1. Coulter I, Hurwitz E, Adams A, et al. The appropriateness of manipulation and mobilization of the cervical spine. RAND. 1996 MR-781-CCR.
    1. Scottish Intercollegiate Guidelines Network. Sign 50: a guideline developer’s handbook. 2010 Available at . Accessed January 1, 2015.
    1. Khorsan R, Crawford C. How to assess the external validity and model validity of therapeutic trials: a conceptual approach to systematic review methodology. Evid Based Complement Alternat Med. 2014;2014:694804.
    1. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP) Arthritis Care Res (Hoboken) 2011;63(Suppl. 11):S240–52.
    1. Hedges LV, Olkin I, editors. Statistical methods for meta-analysis. Orlando, FL: Academic Press; 1985.
    1. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50:1088–101.
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.
    1. GRADE Working Group. Grading of Recommendations Assessment, Development and Evaluation (GRADE) Available at . Accessed November 30, 2011.
    1. de Oliveira RF, Liebano RE, Costa Lda C, Rissato LL, Costa LO. Immediate effects of region-specific and non-region-specific spinal manipulative therapy in patients with chronic low back pain: a randomized controlled trial. Phys Ther. 2013;93:748–56.
    1. Haas M, Groupp E. Kraemer DF. Dose-response for chiropractic care of chronic low back pain. Spine J. 2004;4:574–83.
    1. Hondras MA, Long CR, Cao Y, Rowell RM, Meeker WC. A randomized controlled trial comparing 2 types of spinal manipulation and minimal conservative medical care for adults 55 years and older with subacute or chronic low back pain. J Manipulative Physiol Ther. 2009;32:330–43.
    1. Aure OF, Nilsen JH, Vasseljen O. Manual therapy and exercise therapy in patients with chronic low back pain: a randomized, controlled trial with 1-year follow-up. Spine. 2003;28:525–31. discussion 531–2.
    1. Balthazard P, de Goumoens P, Rivier G, Demeulenaere P, Ballabeni P, Deriaz O. Manual therapy followed by specific active exercises versus a placebo followed by specific active exercises on the improvement of functional disability in patients with chronic non specific low back pain: a randomized controlled trial. BMC Musculoskelet Disord. 2012;13:162.
    1. Bialosky JE, Bishop MD, Robinson ME, Zeppieri G, Jr, George SZ. Spinal manipulative therapy has an immediate effect on thermal pain sensitivity in people with low back pain: a randomized controlled trial. Phys Ther. 2009;89:1292–303.
    1. Ferreira ML, Ferreira PH, Latimer J, et al. Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: a randomized trial. Pain. 2007;131:31–7.
    1. Goodsell M, Lee M, Latimer J. Short-term effects of lumbar posteroanterior mobilization in individuals with low-back pain. J Manipulative Physiol Ther. 2000;23:332–42.
    1. Gudavalli MR, Cambron JA, McGregor M, et al. A randomized clinical trial and subgroup analysis to compare flexion-distraction with active exercise for chronic low back pain. Eur Spine J. 2006;15:1070–82.
    1. Haas M, Vavrek D, Neradilek MB, Polissar N. A path analysis of the effects of the doctor-patient encounter and expectancy in an open-label randomized trial of spinal manipulation for the care of low back pain. BMC Complement Altern Med. 2014;14
    1. Licciardone JC, Stoll ST, Fulda KG, et al. Osteopathic manipulative treatment for chronic low back pain: a randomized controlled trial. Spine. 2003;28:1355–62.
    1. Mackawan S, Eungpinichpong W, Pantumethakul R, Chatchawan U, Hunsawong T, Arayawichanon P. Effects of traditional Thai massage versus joint mobilization on substance P and pain perception in patients with non-specific low back pain. J Bodyw Mov Ther. 2007;11:9–16.
    1. Parker J, Heinking KP, Kappler RE. Efficacy of osteopathic manipulative treatment for low back pain in euhydrated and hypohydrated conditions: a randomized crossover trial. J Am Osteopath Assoc. 2012;112:276–84.
    1. Petersen T, Larsen K, Nordsteen J, Olsen S, Fournier G, Jacobsen S. The McKenzie method compared with manipulation when used adjunctive to information and advice in low back pain patients presenting with centralization or peripheralization: a randomized controlled trial. Spine. 2011;36:1999–2010.
    1. Rasmussen J, Laetgaard J, Lindecrona AL, Qvistgaard E, Bliddal H. Manipulation does not add to the effect of extension exercises in chronic low-back pain (LBP). A randomized, controlled, double blind study. Joint Bone Spine. 2008;75:708–13.
    1. Rasmussen-Barr E, Nilsson-Wikmar L, Arvidsson I. Stabilizing training compared with manual treatment in sub-acute and chronic low-back pain. Man Ther. 2003;8:233–41.
    1. Vismara L, Cimolin V, Menegoni F, et al. Osteopathic manipulative treatment in obese patients with chronic low back pain: a pilot study. Man Ther. 2012;17:451–5.
    1. Ritvanen T, Zaproudina N, Nissen M, Leinonen V, Hanninen O. Dynamic surface electromyographic responses in chronic low back pain treated by traditional bone setting and conventional physical therapy. J Manipulative Physiol Ther. 2007;30:31–7.
    1. Licciardone JC, Minotti DE, Gatchel RJ, Kearns CM, Singh KP. Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial. Ann Fam Med. 2013;11:122–9.
    1. Paatelma M, Kilpikoski S, Simonen R, Heinonen A, Alen M, Videman T. Orthopaedic manual therapy, McKenzie method or advice only for low back pain in working adults: a randomized controlled trial with one year follow-up. J Rehabil Med. 2008;40:858–63.
    1. Cecchi F, Molino-Lova R, Chiti M, et al. Spinal manipulation compared with back school and with individually delivered physiotherapy for the treatment of chronic low back pain: a randomized trial with one-year follow-up. Clin Rehabil. 2010;24:26–36.
    1. Konstantinou K, Foster N, Rushton A, Baxter D, Wright C, Breen A. Flexion mobilizations with movement techniques: the immediate effects on range of movement and pain in subjects with low back pain. J Manipulative Physiol Ther. 2007;30:178–85.
    1. Bicalho E, Setti JA, Macagnan J, Cano JL, Manffra EF. Immediate effects of a high-velocity spine manipulation in paraspinal muscles activity of nonspecific chronic low-back pain subjects. Man Ther. 2010;15:469–75.
    1. Descarreaux M, Blouin JS, Drolet M, Papadimitriou S, Teasdale N. Efficacy of preventive spinal manipulation for chronic low-back pain and related disabilities: a preliminary study. J Manipulative Physiol Ther. 2004;27:509–14.
    1. Geisser ME, Wiggert EA, Haig AJ, Colwell MO. A randomized, controlled trial of manual therapy and specific adjuvant exercise for chronic low back pain. Clin J Pain. 2005;21:463–70.
    1. Cambron JA, Gudavalli MR, Hedeker D, et al. One-year follow-up of a randomized clinical trial comparing flexion distraction with an exercise program for chronic low-back pain. J Altern Complement Med. 2006;12:659–68.
    1. Ferreira PH, Ferreira ML, Maher CG, Refshauge K, Herbert RD, Hodges PW. Changes in recruitment of transversus abdominis correlate with disability in people with chronic low back pain. Br J Sports Med. 2010;44:1166–72.
    1. Licciardone JC, Kearns CM, Hodge LM, Bergamini MV. Associations of cytokine concentrations with key osteopathic lesions and clinical outcomes in patients with nonspecific chronic low back pain: results from the OSTEOPATHIC Trial. J Am Osteopath Assoc. 2012;112:596–605.
    1. Licciardone JC, Kearns CM, Hodge LM, Minotti DE. Osteopathic manual treatment in patients with diabetes mellitus and comorbid chronic low back pain: subgroup results from the OSTEOPATHIC Trial. J Am Osteopath Assoc. 2013;113:468–78.
    1. Licciardone JC, Kearns CM, Minotti DE. Outcomes of osteopathic manual treatment for chronic low back pain according to baseline pain severity: results from the OSTEOPATHIC Trial. Man Ther. 2013;18:533–40.
    1. Kilpikoski S, Alèn M, Paatelma M, Simonen R, Heinonen A, Videman T. Outcome comparison among working adults with centralizing low back pain: secondary analysis of a randomized controlled trial with 1-year follow-up. Adv Physiother. 2009;11:210–17.
    1. Cecchi F, Negrini S, Pasquini G, et al. Predictors of functional outcome in patients with chronic low back pain undergoing back school, individual physiotherapy or spinal manipulation. Eur J Phys Rehabil Med. 2012;48:371–8.
    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;329:1377.
    1. Underwood MR, Morton V, Farrin A. Do baseline characteristics predict response to treatment for low back pain? Secondary analysis of the UK BEAM dataset [ISRCTN32683578] Rheumatology (Oxford) 2007;46:1297–302.
    1. Cook C, Learman K, Showalter C, Kabbaz V, O’Halloran B. Early use of thrust manipulation versus non-thrust manipulation: a randomized clinical trial. Man Ther. 2013;18:191–8.
    1. Lewis JS, Hewitt JS, Billington L, Cole S, Byng J, Karayiannis S. A randomized clinical trial comparing two physiotherapy interventions for chronic low back pain. Spine. 2005;30:711–21.
    1. Hurwitz EL, Morgenstern H, Harber P, et al. The effectiveness of physical modalities among patients with low back pain randomized to chiropractic care: findings from the UCLA low back pain study. J Manipulative Physiol Ther. 2002;25:10–20.
    1. Bronfort G, Evans RL, Maiers M, Anderson AV. Spinal manipulation, epidural injections, and self-care for sciatica: a pilot study for a randomized clinical trial. J Manipulative Physiol Ther. 2004;27:503–8.
    1. Apeldoorn AT, Ostelo RW, Van Helvoirt H, et al. A randomized controlled trial on the effectiveness of a classification-based system for subacute and chronic low back pain. Spine. 2012;37:1347–56.
    1. Cairns MC, Foster NE, Wright C. Randomized controlled trial of specific spinal stabilization exercises and conventional physiotherapy for recurrent low back pain. Spine. 2006;31:E670–81.
    1. Chown M, Whittamore L, Rush M, Allan S, Stott D, Archer M. A prospective study of patients with chronic back pain randomised to group exercise, physiotherapy or osteopathy. Physiotherapy. 2008;94:21–8.
    1. Cuesta-Vargas AI, Garcia-Romero JC, Arroyo-Morales M, Diego-Acosta AM, Daly DJ. Exercise, manual therapy, and education with or without high-intensity deep-water running for nonspecific chronic low back pain: a pragmatic randomized controlled trial. Am J Phys Med Rehabil. 2011;90:526–34. quiz 535–8.
    1. Vibe Fersum K, O’Sullivan P, Skouen JS, Smith A, Kvale A. Efficacy of classification-based cognitive functional therapy in patients with non-specific chronic low back pain: a randomized controlled trial. Eur J Pain. 2013;17:916–28.
    1. Frost H, Lamb SE, Doll HA, Carver PT, Stewart-Brown S. Randomised controlled trial of physiotherapy compared with advice for low back pain. Br Med J. 2004;329:708–11.
    1. Goldby LJ, Moore AP, Doust J, Trew ME. A randomized controlled trial investigating the efficiency of musculoskeletal physiotherapy on chronic low back disorder. Spine. 2006;31:1083–93.
    1. Hawk C, Long CR, Rowell RM, Gudavalli MR, Jedlicka J. A randomized trial investigating a chiropractic manual placebo: a novel design using standardized forces in the delivery of active and control treatments. J Altern Complement Med. 2005;11:109–17.
    1. Hurwitz EL, Morgenstern H, Harber P, et al. A randomized trial of medical care with and without physical therapy and chiropractic care with and without physical modalities for patients with low back pain: 6-month follow-up outcomes from the UCLA low back pain study. Spine. 2002;27:2193–204.
    1. Hsieh LL, Kuo CH, Lee LH, Yen AM, Chien KL, Chen TH. Treatment of low back pain by acupressure and physical therapy: randomised controlled trial. BMJ. 2006;332:696–700.
    1. McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ. Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. J Manipulative Physiol Ther. 2010;33:576–84.
    1. Mehling WE, Hamel KA, Acree M, Byl N, Hecht FM. Randomized, controlled trial of breath therapy for patients with chronic low-back pain. Altern Ther Health Med. 2005;11:44–52.
    1. Mohseni-Bandpei MA, Critchley J, Staunton T, Richardson B. A prospective randomised controlled trial of spinal manipulation and ultrasound in the treatment of chronic low back pain. Physiotherapy. 2006;92:34–42.
    1. Moseley L. Combined physiotherapy and education is efficacious for chronic low back pain. Aust J Physiother. 2002;48:297–302.
    1. Niemistö L, Lahtinen-Suopanki T, Rissanen P, Lindgren K, Sarna S, Hurri H. A randomized trial of combined manipulation, stabilizing exercises, and physician consultation compared to physician consultation alone for chronic low back pain. Spine. 2003;28:2185–91.
    1. Riipinen M, Niemisto L, Lindgren KA, Hurri H. Psychosocial differences as predictors for recovery from chronic low back pain following manipulation, stabilizing exercises and physician consultation or physician consultation alone. J Rehabil Med. 2005;37:152–8.
    1. Wilkey A, Gregory M, Byfield D, McCarthy PW. A comparison between chiropractic management and pain clinic management for chronic low-back pain in a national health service outpatient clinic. J Altern Complement Med. 2008;14:465–73.
    1. Skillgate E, Vingard E, Alfredsson L. Naprapathic manual therapy or evidence-based care for back and neck pain: a randomized, controlled trial. Clin J Pain. 2007;23:431–9.
    1. Casserley-Feeney SN, Daly L, Hurley DA. The access randomized clinical trial of public versus private physiotherapy for low back pain. Spine. 2012;37:85–96.
    1. Nagrale AV, Patil SP, Gandhi RA, Learman K. Effect of slump stretching versus lumbar mobilization with exercise in subjects with non-radicular low back pain: a randomized clinical trial. J Man Manip Ther. 2012;20:35–42.
    1. Senna MK, Machaly SA. Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcome? Spine. 2011;36:1427–37.
    1. Cook CE, Showalter C, Kabbaz V, O’Halloran B. Can a within/between-session change in pain during reassessment predict outcome using a manual therapy intervention in patients with mechanical low back pain? Man Ther. 2012;17:325–9.
    1. Donaldson M, Learman K, O’Halloran B, Showalter C, Cook C. The role of patients’ expectation of appropriate initial manual therapy treatment in outcomes for patients with low back pain. J Manipulative Physiol Ther. 2013;36:276–83.
    1. Goldstein MS, Morgenstern H, Hurwitz EL, Yu F. The impact of treatment confidence on pain and related disability among patients with low-back pain: results from the University of California, Los Angeles, low-back pain study. Spine J. 2002;2:391–9. discussion 399–401.
    1. Skillgate E, Bohman T, Holm LW, Vingard E, Alfredsson L. The long-term effects of naprapathic manual therapy on back and neck pain—results from a pragmatic randomized controlled trial. BMC Musculoskelet Disord. 2010;11:26.
    1. Yu F, Morgenstern H, Hurwitz E, Berlin TR. Use of a Markov transition model to analyse longitudinal low-back pain data. Stat Methods Med Res. 2003;12:321–31.
    1. Cook CE, Learman KE, O’Halloran BJ, et al. Which prognostic factors for low back pain are generic predictors of outcome across a range of recovery domains? Phys Ther. 2013;93:32–40.
    1. Rubinstein SM, Knol DL, Leboeuf-Yde C, van Tulder MW. Benign adverse events following chiropractic care for neck pain are associated with worse short-term outcomes but not worse outcomes at three months. Spine. 2008;33:E950–6.
    1. Rubinstein SM, Leboeuf-Yde C, de Koekkoek TE, Pfeifle CE, Van Tulder MW. Predictors of adverse events following chiropractic care for patients with neck pain. J Manipulative Physiol Ther. 2008;31:94–103.
    1. Rubinstein SM, Leboeuf-Yde C, Knol DL, de Koekkoek TE, Pfeifle CE, van Tulder MW. The benefits outweigh the risks for patients undergoing chiropractic care for neck pain: a prospective, multicenter, cohort study. J Manipulative Physiol Ther. 2007;30:408–18.
    1. Airaksinen O, Brox JI, Cedraschi C, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(Suppl. 2):S192–300.
    1. Delitto A, George SZ, Van Dillen LR, et al. Low back pain. J Orthop Sports Phys Ther. 2012;42:A1–57.
    1. Cowan P, American Chronic Pain Association . Practice guidelines for low back pain: consumer’s guide. American Chronic Pain Association; 2008.
    1. Koes BW, van Tulder M, Lin CW, Macedo LG, McAuley J, Maher C. An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. Eur Spine J. 2010;19:2075–94.
    1. Pillastrini P, Gardenghi I, Bonetti F, et al. An updated overview of clinical guidelines for chronic low back pain management in primary care. Joint Bone Spine. 2012;79:176–85.
    1. Cheng JS, Lee MJ, Massicotte E, et al. Clinical guidelines and payer policies on fusion for the treatment of chronic low back pain. Spine. 2011;36(Suppl. 21):S144–63.
    1. Rubinstein SM, van Middelkoop M, Assendelft WJ, de Boer MR, van Tulder MW. Spinal manipulative therapy for chronic low-back pain: an update of a Cochrane review. Spine. 2011;36:E825–46.
    1. Orrock PJ, Myers SP. Osteopathic intervention in chronic non-specific low back pain: a systematic review. BMC Musculoskelet Disord. 2013;14:129.
    1. Ladeira CE. Evidence based practice guidelines for management of low back pain: physical therapy implications. Rev Bras Fisioter. 2011;15:190–9.
    1. Vellucci R. Heterogeneity of chronic pain. Clin Drug Investig. 2012;32(Suppl. 1):3–10.

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