The effectiveness of Spinal Manipulative Therapy (SMT) In the management of nonspecific Low Back Pain (LBP)

Abstract

A systematic review of a number of studies in order to verify the real effectiveness of Spinal Manipulative Therapy (SMT) for management of nonspecific Low Back pain in order to relieve pain, improve function and diminish disability. It is known that the diagnosis of low back pain is a difficult matter, due to different causes related to it, not always readily apparent, considering the main distinction between specific and non-specific low back pain, in this review, a special attention has been dedicated on the second one. Despite many published randomized clinical trials, a substantial number of reviews and several clinical guidelines, the real effectiveness of this therapy to manage nonspecific low back pain is still minimal. Following the most recent North American Spine Society (NASS) guidelines, this review considers selected and high quality studies with more stringent criteria of evidence-based admissibility, and by the way, a special attention has been paid on the studies that, more than other, tried to assess the effect of spinal manipulation SMT compared to other kind of therapies in patients with nonspecific LBP. It should be noted that this study is designed to be a simple review of the best evidence based recommendations so it should not be seen as a standard of care, or a treatment protocol with type, frequency and duration of intervention available for everyone.