Landmark Systematic Review Proves the Superiority of Chiropractic Adjustment for Spinal Healthcare


Hidalgo, B. et al. (2014) The efficacy of manual therapy and exercise for different stages of non-specific low back
pain: an update of systematic reviews. Journal of Manual and Manipulative Therapy; 22(2): 59-74

Key Concepts:
This paper, headed by a medical neuroscientist, is the first and only systematic review to differentiate and
individually rate the effectiveness of chiropractic adjustment/thrust manipulation technique in comparison to
physiotherapy/physical therapy mobilization.
Previous systematic reviews have combined data regarding the effectiveness of chiropractic adjustment
technique and physical therapy/physiotherapy mobilization. This systematic review clearly shows the clinical
superiority of chiropractic adjustment compared to mobilization.
It also explains why the effectiveness of chiropractic adjustment is so often underestimated. Arbitrarily pooling
the highly effective benefits of chiropractic adjustment with the ineffective results of mobilizations has resulted
in an invalid underestimation of the benefits of chiropractic and an overestimation of the benefits of physical
therapy/physiotherapy mobilization.

“Firstly, in comparison to previous reports of limited evidence showing no difference between true and sham
manipulation, the results of this systematic review show moderate to strong evidence for the beneficial effects
of thrust manipulation in comparison to sham-thrust manipulation.”

“STRONG evidence in favor of MT1 [thrust manipulation/chiropractic adjustment] in comparison to sham MT1
for acute and subacute LBP, for pain, function, overall health and quality of life improvements in the short term
(<3 months).”

“MODERATE evidence for NO DIFFERENCE between MT2 [physical therapy/physiotherapy mobilization] and
sham ultra sound in terms of pain reduction and functional improvements from very short to short term in
acute LBP.”

Key Take Home Points:
The evidence is overwhelmingly clear. Chiropractic adjustment is the most effective spinal healthcare intervention in terms of pain-relief, functional improvement, and improvements in quality of life. Scientific evidence matters, and chiropractic is the most evidence-based spinal healthcare option available. You don’t need to “believe” in chiropractic care for it to work – you just need to receive it.


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