Is Spinal Manipulation Effective for Pain? An Overview of Systematic Reviews.

OBJECTIVE: This article is aimed at critically evaluating the evidence from systematic reviews (SRs) of spinal manipulation in patients with pain. Design: The study was designed as a SR of SRs. METHODS: Four electronic databases were searched to identify all relevant articles of the effectiveness of spinal manipulation for pain. SRs were defined as articles employing a repeatable methods section. RESULTS: Twenty-two SRs relating to the following pain conditions: low back pain (N = 6), headache (N = 5), neck pain (N = 4), any medical problem (N = 1), carpal tunnel syndrome (N = 1), dysmenorrhea (N = 1), fibromyalgia (N = 1), lateral epicondylitis (N = 1), musculoskeletal conditions (N = 1) and nonspinal pain (N = 1), were included. Positive or, for multiple SR, unanimously positive conclusions were drawn for none of the conditions mentioned earlier. LIMITATION: Publication bias as a well-known phenomenon may have been inherited in this article. CONCLUSION: Collectively, these data fail to demonstrate that spinal manipulation is an effective intervention for pain management.