Benefits and Harms of Spinal Manipulative Therapy for Treatment of Chronic Low Back Pain

Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials

A ChiroSecure Research Update

Abstract: Objective To assess the benefits and harms of spinal manipulative therapy (SMT) for the treatment of chronic low back pain.

Discussions: 47 randomised controlled trials including a total of 9211 participants were identified, who were on average middle aged (35-60 years). Most trials compared SMT with recommended therapies. Moderate quality evidence suggested that SMT has similar effects to other recommended therapies for short term pain relief (mean difference −3.17, 95% confidence interval −7.85 to 1.51) and a small, clinically better improvement in function (SMD −0.25, 95% confidence interval −0.41 to −0.09). High quality evidence suggested that compared with non-recommended therapies SMT results in small, not clinically better effects for short term pain relief (mean difference −7.48, −11.50 to −3.47) and small to moderate clinically better improvement in function (SMD −0.41, −0.67 to −0.15). In general, these results were similar for the intermediate and long term outcomes as were the effects of SMT as an adjuvant therapy. Evidence for sham SMT was low to very low quality; therefore these effects should be considered uncertain. Statistical heterogeneity could not be explained. About half of the studies examined adverse and serious adverse events, but in most of these it was unclear how and whether these events were registered systematically. Most of the observed adverse events were musculoskeletal related, transient in nature, and of mild to moderate severity. One study with a low risk of selection bias and powered to examine risk (n=183) found no increased risk of an adverse event (relative risk 1.24, 95% confidence interval 0.85 to 1.81) or duration of the event (1.13, 0.59 to 2.18) compared with sham SMT. In one study, the Data Safety Monitoring Board judged one serious adverse event to be possibly related to SMT.

Conclusion SMT produces similar effects to recommended therapies for chronic low back pain, whereas SMT seems to be better than non-recommended interventions for improvement in function in the short term. Clinicians should inform their patients of the potential risks of adverse events associated with SMT.

Reference: Rubinstein, S. M., de Zoete, A., van Middelkoop, M., Assendelft, W. J. J., de Boer, M. R., & van Tulder, M. W. (2019). Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: Systematic review and meta-analysis of randomised controlled trials. BMJ, 364, l689. https://doi.org/10.1136/bmj.l689 [1]

Today, chiropractors must protect themselves from claims.

You owe it to yourself and your loved ones to make sure you're protected.

Choosing a professional liability malpractice insurance carrier is one of the most important decisions facing chiropractors today.

You must have trust and confidence that the malpractice insurance program you select is right and will be there for you.

ChiroSecure
1-866-80-CHIRO
1-866-802-4476
https://ChiroSecure.com

The ChiroSecure malpractice insurance program provides superior malpractice coverage with many unique insurance features and long-term, solid protection.

Our philosophy of combining discerning Chiropractic underwriting practices, competitive insurance premiums and aggressive malpractice claim management is designed to protect you and your future.

ChiroSecure is committed to providing you exceptional quality protection by offering you the most comprehensive professional liability malpractice coverage available at the most competitive rates.

The best coverage at the best price:

- Chiropractic Malpractice Insurance
- Massage Therapist Malpractice Policies
- Acupuncture Malpractice Insurance Polices
- Business Owner Policies (General Liability)
- Workers Compensation
- Life Insurance
- Chiropractors Disability Insurance
- Business Overhead Expense

Custom-tailored policies to fit your chiropractic business' unique needs.

ChiroSecure offers chiropractors the best professional liability malpractice coverage at the absolute best price!

We pride ourselves on consistently outperforming all others in price and service.

ChiroSecure provides unmatched strength, winning defense and superior insurance solutions to doctors of chiropractic.

Our team will assist you with risk management tools and help educate, as well as support your need for a customer service team that will look out for your best interest in a compassionate manner.

ChiroSecure delivers for you when it matters most.

Get the peace of mind knowing you have safe and sound malpractice insurance coverage you can depend on!

Get a Quick Quote:
https://www.chirosecure.com/quick-quotes/malpractice-quick-quote/

ChiroSecure
1-866-80-CHIRO
1-866-802-4476
https://ChiroSecure.com

Видео Benefits and Harms of Spinal Manipulative Therapy for Treatment of Chronic Low Back Pain канала Chirosecure Malpractice Insurance