Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis
SOURCE: JAMA. 2017 (Apr 11); 317 (14): 1451–1460
Neil M. Paige, MD, MSHS, Isomi M. Miake-Lye, BA,
Marika Suttorp Booth, MS, Jessica M. Beroes, BS,
Aram S. Mardian, MD, Paul Dougherty, DC,
Richard Branson, DC, Baron Tang, PT, DPT,
Sally C. Morton, PhD, Paul G. Shekelle, MD, PhD
West Los Angeles Veterans Affairs Medical Center,
Los Angeles, California
Commentary from the Illinois Chiropractic Society
JAMA Endorses Spinal Manipulation
For the second time in as many months, a prominent medical journal has endorsed spinal manipulation for the management of low back pain.  On April 11th 2017, JAMA published a systematic review of 26 randomized clinical trials in order to evaluate the safety and effectiveness of spinal manipulation for low back pain.
The authors concluded:
“Among patients with acute low back pain, spinal manipulative therapy was associated with improvements in pain and function with only transient minor musculoskeletal harms.”
This study comes on the heels of a February 2017 Clinical Practice Guideline from the American College of Physicians recommending spinal manipulation for acute, sub-acute, and chronic low back pain (LBP). 
These high-quality studies in respected medical journals add to a growing list of scientific support for spinal manipulation therapy (SMT). So why are our offices not flooded with medical referrals? An editorial accompanying the JAMA study provides perspective as to why some medical providers may be reluctant to refer to chiropractic physicians:
The emerging health care model dictates that all providers embrace proven clinically effective treatments, regardless of long-standing philosophical bias. If we expect medical providers to advance their thinking to accept validated chiropractic therapies, we must first be willing to reciprocate. By working together to provide evidence-based patient-centric care, we can advance our profession to become the undeniable first choice for both patients and providers.
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IMPORTANCE: Acute low back pain is common and spinal manipulative therapy (SMT) is a treatment option. Randomized clinical trials (RCTs) and meta-analyses have reported different conclusions about the effectiveness of SMT.
OBJECTIVE: To systematically review studies of the effectiveness and harms of SMT for acute (≤6 weeks) low back pain.