Does spinal manipulation have specific treatment effects?
OBJECTIVE
To investigate the question whether or not spinal manipulation is associated with specific treatment effects.


METHODS
Literature searches were carried out in Medline, Embase and The Cochrane Library. All sham-controlled trials of spinal manipulation were considered.


RESULTS
Seven such studies were located. Their methodological quality was variable but three trials adhered to the highest standards of scientific rigour. Collectively these data do not show therapeutic effects beyond placebo. In particular, the three most rigorous studies were negative.


CONCLUSIONS
The few sham-controlled trials that do exist show that this methodology is, in principle, applicable also to spinal manipulation. The results available to date suggest that the therapeutic success of spinal manipulation is largely due to a placebo effect.
Ernst
E
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Department of Complementary Medicine, School of Postgraduate Medicine and Health Sciences, University of Exeter, 25 Victoria Park Road, Exeter EX2 4NT, UK.
D006801:Humans; D020393:Manipulation, Spinal; D016896:Treatment Outcome