• McDowall CA

• Evidence-Based Chiropractic
• Manipulation, Spinal
• Open Access Document
• Review Literature as Topic

Chiropractors  are  primary  care  providers  for  spinal  and  musculoskeletal  conditions.  Current  literature recognises the evidence for benefits of common musculoskeletal complaints including back and neck pain, a minority of  patient  visits  are  non-musculoskeletal  in  nature.  The  hypothesis  that  spinal  manipulative  therapy  does  have  an effect  on  the  patient  beyond  muscle  and  joint  pain  is  a  claim  that  has  been  scrutinised  inside  and  outside  the profession  possibly  due  to  the  absence  of  high  level  evidence  to  support  those  claims.  Electronic  databases  were searched  using  Mesh  terms  and  selection  criteria  was  met.  The  search  yielded  23  papers,  the  literature  was evaluated  using  selective  critical  appraisal  tools.  Of  those,  ten  were  randomised  controlled  trials,  nine  were systematic reviews, one was a cohort study and three were surveys. Four papers were evaluated as no evidence, 14 were evaluated as inconclusive, four papers had conclusive evidence and there was a moderate to low range of bias across all papers. The claim that SMT can affect the patient beyond muscle and joint pain cannot be substantiated due to the methodological bias and inconclusive evidence of the current literature. Improvements for future evidence quality  may  increase  with  better  objective  outcome  measures, specified  topics  of  research,  double-blinding  in randomised controlled trials and more controlled cohort studies to improve reproducibility.

Author keywords: Spinal manipulative therapy - Non-musculoskeletal - Evidence - Chiropractic.

This abstract is reproduced with the permission of the publisher; click on the above link for free full text. Online access only. PDF