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Daily Archives: July 9, 2014

Cost-Effectiveness of Manual Therapy for the Management of Musculoskeletal Conditions: A Systematic Review and Narrative Synthesis of Evidence From Randomized Controlled Trials

By |July 9, 2014|Cost-Effectiveness|

Cost-Effectiveness of Manual Therapy for the Management of Musculoskeletal Conditions: A Systematic Review and Narrative Synthesis of Evidence From Randomized Controlled Trials

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2014 (Jul); 37 (6): 343–362

Alexander Tsertsvadze, MD, MSc,
Christine Clar, PhD, Rachel Court, MA,
Aileen Clarke, MD, Hema Mistry, PhD,
Paul Sutcliffe, DPhil

Senior Research Fellow,
Warwick Medical School,
University of Warwick, Coventry, UK.


OBJECTIVES:   The purpose of this study was to systematically review trial-based economic evaluations of manual therapy relative to other alternative interventions used for the management of musculoskeletal conditions.

METHODS:   A comprehensive literature search was undertaken in major medical, health-related, science and health economic electronic databases.

RESULTS:   Twenty-five publications were included (11 trial-based economic evaluations). The studies compared cost-effectiveness and/or cost-utility of manual therapy interventions to other treatment alternatives in reducing pain (spinal, shoulder, ankle). Manual therapy techniques (eg, osteopathic spinal manipulation, physiotherapy manipulation and mobilization techniques, and chiropractic manipulation with or without other treatments) were more cost-effective than usual general practitioner (GP) care alone or with exercise, spinal stabilization, GP advice, advice to remain active, or brief pain management for improving low back and shoulder pain/disability. Chiropractic manipulation was found to be less costly and more effective than alternative treatment compared with either physiotherapy or GP care in improving neck pain.

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