National Institutes of Health • National Center for Complementary and Alternative Medicine

Spinal Manipulation for Low-Back Pain

May 2012

Back pain is one of the most common health complaints, affecting 8 out of 10 people at some point during their lives. The lower back is the area most often affected. For many people, back pain goes away on its own after a few days or weeks. But for others, the pain becomes chronic and lasts for months or years. Low-back pain can be debilitating, and it is a challenging condition to diagnose, treat, and study. The total annual costs of low-back pain in the United States—including lost wages and reduced productivity—are more than $100 billion.

Spinal manipulation—sometimes called “spinal manipulative therapy”—is practiced by health care professionals such as chiropractors, osteopathic physicians, naturopathic physicians, physical therapists, and some medical doctors. Practitioners perform spinal manipulation by using their hands or a device to apply a controlled force to a joint of the spine. The amount of force applied depends on the form of manipulation used. The goal of the treatment is to relieve pain and improve physical functioning.

This issue provides the state of the science about spinal manipulation for low-back pain.

Clinical Guidelines

Diagnosis and Treatment of Low-Back Pain (Annals of Internal Medicine) [494KB PDF]
Osteopathic Manipulative Treatment for Low-Back Pain (Journal of the American Osteopathic Association) [340KB PDF]

Scientific Literature

Systematic Reviews/Reviews/Meta-analysis (PubMed®)
Randomized Controlled Trials (PubMed®)

Research Spotlights

Information for Your Patients

NCCAM Clinical Digest is a service of the National Center for Complementary and Alternative Medicine, NIH, DHHS. NCCAM Clinical Digest, a monthly e-newsletter, offers evidence-based information on CAM, including scientific literature searches, summaries of NCCAM-funded research, fact sheets for patients, and more.

The National Center for Complementary and Alternative Medicine is dedicated to exploring complementary and alternative healing practices in the context of rigorous science, training CAM researchers, and disseminating authoritative information to the public and professionals. For additional information, call NCCAM's Clearinghouse toll-free at 1-888-644-6226, or visit the NCCAM Web site at nccam.nih.gov. NCCAM is 1 of 27 institutes and centers at the National Institutes of Health, the Federal focal point for medical research in the United States.

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