Effectiveness and Safety of Spinal Manipulation for Low Back Pain or Neck Pain:An Overview of Systematic Reviews_Chinese Journal of Evidence-Based Medicine

Authors：

 ANGuang-hui ^1,2 , ZAHOYi ¹ , YAOFei ¹ ,  YANJun-tao ² , GONGLi ² , KONGLing-jun ³ , YUANWei-an ⁴ , CHENYao-long ⁵

1. Acupuncture and Tuina College, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China;
2. Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of TCM, Shanghai 200437, China;
3. Institute of Tuina in Study of Chinese Medicine of Shanghai, Shanghai 200437, China;
4. Shuguang Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China;
5. Chinese GRADE Center/Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China;

Corresponding author：

YANJun-tao, Email: doctoryjt@sohu.com

Keywords：

Spinal manipulation; Low back pain; Neck pain; Overview of systematic reviews; AMSTAR tool

DOI：

10.7507/1672-2531.20150169

Video：

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Objectives To overview the systematic reviews/meta-analyses (SRs/MAs) of effectiveness and safety of spinal manipulation for low back pain or neck pain. Methods We electronically searched databases including PubMed, EMbase, The Cochrane Library (Issue 1, 2015), CBM, CNKI, WanFang Data and VIP to collect SRs/MAs of spinal manipulation for low back pain or neck pain from inception to January 30^th, 2015. Two reviewers independently screened literature, extracted data, and then AMSTAR tool was used to assess the methodological quality of included SRs/MAs. Results A total of 21 SRs/MAs were included. Twenty of them assessed the methodological quality of included original randomized controlled trials (RCTs) with different tools:2 used Jadad scale, 5 used PEDro scale, 6 used Cochrane bias risk assessment tool and 7 used other tools. The assessment results of AMSTAR tool suggested that:among 11 items, the item 1 of "Was an ‘a priori’ design provided" (18 SRs/MAs did not provide) and item 4 of "Was a list of studies (included and excluded) provided" (18 SRs/MAs did not provide) appeared to be the most problematic, followed by item 10 of "Was the likelihood of publication bias assessed" (14 SRs/MAs did not assess the publication bias) and item 11 of "Was the conflict of interest stated" (14 SRs/MAs did not provide the conflict of interest and 4 were incomplete). Conclusion The methodological quality of included SRs/MAs is poor. The limited evidence showed that spinal manipulation is more effective for acute low back pain than chronic low back pain, and the short term effect is better than the long term one. Different spinal manipulation techniques have various effects but are all safe. Chiropractic manipulation may have the best effect. Due to the limitation of quality and quantity of included SRs/MAs, there may be potential bias in the above conclusion that needs more high quality studies to verify.

Citation： ANGuang-hui, ZAHOYi, YAOFei, YANJun-tao, GONGLi, KONGLing-jun, YUANWei-an, CHENYao-long. Effectiveness and Safety of Spinal Manipulation for Low Back Pain or Neck Pain:An Overview of Systematic Reviews. Chinese Journal of Evidence-Based Medicine, 2015, 15(9): 1010-1017. doi: 10.7507/1672-2531.20150169 Copy

1.	Fritz S, Snyder WR. Mosby's fundamentals of therapeutic massage. St. Louis, MO:Mosby, 2000.
2.	李义凯. 脊柱推拿的历史. 颈腰痛杂志, 2001, 22(2):169-171.
3.	李银兰. 推拿结合关节松动术治疗肩周炎. 中国康复, 2008, (4):263-263.
4.	Wolsko PM, Eisenberg DM, Davis RB, et al. Patterns and perceptions of care for treatment of back and neck pain:results of a national survey. Spine, 2003, 28(3):292-297.
5.	杨佳, 张瑞春, 王新军. 推拿与牵引治疗神经根型颈椎病的Meta分析. 环球中医药, 2013, 6(9):641-648.
6.	张军, 吴宗蔚, 马笃军, 等. 推拿治疗便秘临床研究文献的Meta分析. 湖南中医杂志, 2013 (3):127-130.
7.	中医推拿. Available at:http://www.zhzyw.org/zyts/zytn/.
8.	师宁宁, 沈国权. 中国脊柱推拿手法的发展与评价. 按摩与康复医学, 2013, 4(8):11-13.
9.	谢凌, 李义凯. 脊柱推拿治疗腰背痛疗效的研究进展. 中医外治杂志. 2014, 23(4):49-52.
10.	Ernst E, Canter PH. A systematic review of systematic reviews of spinal manipulation. J R Soc Med, 2006, 99(4):192-196.
11.	World Health Organization. WHO methods and data sources for global burden of disease estimates 2000-2011. Global Health Estimates Technical Paper WHO/HIS/HSI/GHE, 2013.
12.	Airaksinen O, Hildebrandt J, Mannion AF, et al. European Guidelines for the Management of Chronic Non-Specific Low Back Pain, 2004. Available at:http://www.backpaineurope.org/web/files/WG2_Guidelines.pdf.
13.	Bergman S, Herrstrom P, Hogstrom K, et al. Chronic musculoskeletal pain, prevalence rates, and sociodemographic associations in a Swedish population study. J Rheumatol, 2001, 28(6):1369-1377.
14.	Borghouts JA, Koes BW, Vondeling H, et al. Cost-of-illness of neck pain in the Netherlands in 1996. Pain, 1999, 80(3):629-636.
15.	Vos T, Flaxman A D, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010:a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2013, 380(9859):2163-2196.
16.	Hong J, Reed C, Novick D, et al. Costs associated with treatment of chronic low back pain:an analysis of the UK General Practice Research Database. Spine (Phila Pa 1976), 2013, 38(1):75-82.
17.	Kleinman N, Patel AA, Benson C, et al. Economic burden of back and neck pain:effect of a neuropathic component. Popul Health Manag, 2014, 17(4):224-232.
18.	Martin BI, Deyo RA, Mirza SK, et al. Expenditures and health status among adults with back and neck problems. JAMA, 2008, 299(6):656-664.
19.	马子龙, 朱立国, 冯敏山, 等. 国内脊柱手法生物力学研究进展. 北京中医药, 2013, 32(2):157-159.
20.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011.
21.	杨克虎, 刘雅莉, 袁金秋, 等. 发展和完善中的系统评价再评价. 中国循证儿科杂志, 2011, 6(1):54-57.
22.	Worswick J, Wayne SC, Bennett R, et al. Improving quality of care for persons with diabetes:an overview of systematic reviews-what does the evidence tell us? Syst Rev, 2013, 2(1):26.
23.	Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR:a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol, 2007, 7(1):10.
24.	Ernst E. Chiropractic spinal manipulation for neck pain:a systematic review. J Pain, 2003, 4(8):417-421.
25.	Ferreira ML, Ferreira PH, Latimer J, et al. Does spinal manipulative therapy help people with chronic low back pain? Aust J Physiother, 2002, 48(4):277-284.
26.	Assendelft WJ, Koes BW, van der Heijden GJ, et al. The effectiveness of chiropractic for treatment of low back pain:an update and attempt at statistical pooling. J Manipulative Physiol Ther, 1996, 19(8):499-507.
27.	Assendelft WJ, Koes BW, van der Heijden G, et al. The Efficacy of Chiropractic Manipulation for Back Pain:Blinded Review of the Relevant Randomized Clinical Trials. J Manipulative Physiol Ther, 1992, 15(8):487-494.
28.	Bronfort G, Haas M, Evans RL, et al. Efficacy of spinal manipulation and mobilization for low back pain and neck pain:a systematic review and best evidence synthesis. Spine J, 2004, 4(3):335-356.
29.	Ferreira ML, Ferreira PH, Latimer J, et al. Efficacy of spinal manipulative therapy for low back pain of less than three months' duration. J Manipulative Physiol Ther, 2003, 26(9):593-601.
30.	Koes BW, Assendelft WJ, Van der Heijden GJ, et al. Spinal manipulation for low back pain:an updated systematic review of randomized clinical trials. Spine (Phila Pa 1976), 1996, 21(24):2860-2871.
31.	Assendelft WJ, Morton SC, Yu EI, et al. Spinal manipulative therapy for low back pain:A meta-analysis of effectiveness relative to other therapies. Ann Intern Med, 2003, 138(11):871-881.
32.	Standaert CJ, Friedly J, Erwin MW, et al. Comparative effectiveness of exercise, acupuncture, and spinal manipulation for low back pain. Spine, 2011, 36 (21 Suppl):S120-S130.
33.	Walker BF, French SD, Grant W, et al. A Cochrane review of combined chiropractic interventions for low-back pain. Spine, 2011, 36(3):230-242.
34.	Parkinson L, Sibbritt D, Bolton P, et al. Well-being outcomes of chiropractic intervention for lower back pain:a systematic review. Clin rheumatol, 2013, 32(2):167-180.
35.	Rubinstein SM, van Middelkoop M, Assendelft WJ, et al. Spinal manipulative therapy for chronic low-back pain. Cochrane Database Syst Rev, 2011, 2:CD008112.
36.	Rubinstein SM, Terwee CB, Assendelft WJ, et al. Spinal manipulative therapy for acute low-back pain. Cochrane Database Syst Rev, 2012, 9:CD008880.
37.	Ernst E, Canter PH. Chiropractic spinal manipulation treatment for back pain? A systematic review of randomised clinical trials. Phys Ther Rev, 2003, 8(2):85-91.
38.	Huisman PA, Speksnijder CM, De Wijer A. The effect of thoracic spine manipulation on pain and disability in patients with non-specific neck pain:a systematic review. Disabil Rehabil, 2013, 35(20):1677-1685.
39.	Kuczynski JJ, Schwieterman B, Columber K, et al. Effectiveness of physical therapist administered spinal manipulation for the treatment of low back pain:a systematic review of the literature. Int J Sports Phys Ther, 2012, 7(6):647.
40.	Merepeza A. Effects of spinal manipulation versus therapeutic exercise on adults with chronic low back pain:a literature review. J Can Chir Assoc, 2014, 58(4):456.
41.	Mohseni-Bandpei MA, Stephenson R, Richardson B. Spinal manipulation in the treatment of low back pain:a review of the literature with particular emphasis on randomized controlled clinical trials. Phys Ther Rev, 1998, 3(4):185-194.
42.	Orrock PJ, Myers SP. Osteopathic intervention in chronic non-specific low back pain:a systematic review. BMC Musculoskelet Disord, 2013, 14(1):129.
43.	Licciardone JC, Brimhall AK, King LN. Osteopathic manipulative treatment for low back pain:a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord, 2005, 6(1):43.
44.	Franke H, Franke JD, Fryer G. Osteopathic manipulative treatment for nonspecific low back pain:A systematic review and meta-analysis. BMC Musculoskelet Disord, 2014, 15(1):286.
45.	Moher D, Tetzlaff J, Tricco AC, et al. Epidemiology and reporting characteristics of systematic reviews. PLoS Med, 2007, 4(3):e78.
46.	李静, 李幼平. 不断完善与发展的Cochrane系统评价. 中国循证医学杂志, 2008, 8(9):742-743.
47.	屈云, 何俐, 刘鸣. Cochrane系统评价的基本方法. 中国临床康复, 2003, 7(4):532.

1. Fritz S, Snyder WR. Mosby's fundamentals of therapeutic massage. St. Louis, MO:Mosby, 2000.
2. 李义凯. 脊柱推拿的历史. 颈腰痛杂志, 2001, 22(2):169-171.
3. 李银兰. 推拿结合关节松动术治疗肩周炎. 中国康复, 2008, (4):263-263.
4. Wolsko PM, Eisenberg DM, Davis RB, et al. Patterns and perceptions of care for treatment of back and neck pain:results of a national survey. Spine, 2003, 28(3):292-297.
5. 杨佳, 张瑞春, 王新军. 推拿与牵引治疗神经根型颈椎病的Meta分析. 环球中医药, 2013, 6(9):641-648.
6. 张军, 吴宗蔚, 马笃军, 等. 推拿治疗便秘临床研究文献的Meta分析. 湖南中医杂志, 2013 (3):127-130.
7. 中医推拿. Available at:http://www.zhzyw.org/zyts/zytn/.
8. 师宁宁, 沈国权. 中国脊柱推拿手法的发展与评价. 按摩与康复医学, 2013, 4(8):11-13.
9. 谢凌, 李义凯. 脊柱推拿治疗腰背痛疗效的研究进展. 中医外治杂志. 2014, 23(4):49-52.
10. Ernst E, Canter PH. A systematic review of systematic reviews of spinal manipulation. J R Soc Med, 2006, 99(4):192-196.
11. World Health Organization. WHO methods and data sources for global burden of disease estimates 2000-2011. Global Health Estimates Technical Paper WHO/HIS/HSI/GHE, 2013.
12. Airaksinen O, Hildebrandt J, Mannion AF, et al. European Guidelines for the Management of Chronic Non-Specific Low Back Pain, 2004. Available at:http://www.backpaineurope.org/web/files/WG2_Guidelines.pdf.
13. Bergman S, Herrstrom P, Hogstrom K, et al. Chronic musculoskeletal pain, prevalence rates, and sociodemographic associations in a Swedish population study. J Rheumatol, 2001, 28(6):1369-1377.
14. Borghouts JA, Koes BW, Vondeling H, et al. Cost-of-illness of neck pain in the Netherlands in 1996. Pain, 1999, 80(3):629-636.
15. Vos T, Flaxman A D, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010:a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2013, 380(9859):2163-2196.
16. Hong J, Reed C, Novick D, et al. Costs associated with treatment of chronic low back pain:an analysis of the UK General Practice Research Database. Spine (Phila Pa 1976), 2013, 38(1):75-82.
17. Kleinman N, Patel AA, Benson C, et al. Economic burden of back and neck pain:effect of a neuropathic component. Popul Health Manag, 2014, 17(4):224-232.
18. Martin BI, Deyo RA, Mirza SK, et al. Expenditures and health status among adults with back and neck problems. JAMA, 2008, 299(6):656-664.
19. 马子龙, 朱立国, 冯敏山, 等. 国内脊柱手法生物力学研究进展. 北京中医药, 2013, 32(2):157-159.
20. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011.
21. 杨克虎, 刘雅莉, 袁金秋, 等. 发展和完善中的系统评价再评价. 中国循证儿科杂志, 2011, 6(1):54-57.
22. Worswick J, Wayne SC, Bennett R, et al. Improving quality of care for persons with diabetes:an overview of systematic reviews-what does the evidence tell us? Syst Rev, 2013, 2(1):26.
23. Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR:a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol, 2007, 7(1):10.
24. Ernst E. Chiropractic spinal manipulation for neck pain:a systematic review. J Pain, 2003, 4(8):417-421.
25. Ferreira ML, Ferreira PH, Latimer J, et al. Does spinal manipulative therapy help people with chronic low back pain? Aust J Physiother, 2002, 48(4):277-284.
26. Assendelft WJ, Koes BW, van der Heijden GJ, et al. The effectiveness of chiropractic for treatment of low back pain:an update and attempt at statistical pooling. J Manipulative Physiol Ther, 1996, 19(8):499-507.
27. Assendelft WJ, Koes BW, van der Heijden G, et al. The Efficacy of Chiropractic Manipulation for Back Pain:Blinded Review of the Relevant Randomized Clinical Trials. J Manipulative Physiol Ther, 1992, 15(8):487-494.
28. Bronfort G, Haas M, Evans RL, et al. Efficacy of spinal manipulation and mobilization for low back pain and neck pain:a systematic review and best evidence synthesis. Spine J, 2004, 4(3):335-356.
29. Ferreira ML, Ferreira PH, Latimer J, et al. Efficacy of spinal manipulative therapy for low back pain of less than three months' duration. J Manipulative Physiol Ther, 2003, 26(9):593-601.
30. Koes BW, Assendelft WJ, Van der Heijden GJ, et al. Spinal manipulation for low back pain:an updated systematic review of randomized clinical trials. Spine (Phila Pa 1976), 1996, 21(24):2860-2871.
31. Assendelft WJ, Morton SC, Yu EI, et al. Spinal manipulative therapy for low back pain:A meta-analysis of effectiveness relative to other therapies. Ann Intern Med, 2003, 138(11):871-881.
32. Standaert CJ, Friedly J, Erwin MW, et al. Comparative effectiveness of exercise, acupuncture, and spinal manipulation for low back pain. Spine, 2011, 36 (21 Suppl):S120-S130.
33. Walker BF, French SD, Grant W, et al. A Cochrane review of combined chiropractic interventions for low-back pain. Spine, 2011, 36(3):230-242.
34. Parkinson L, Sibbritt D, Bolton P, et al. Well-being outcomes of chiropractic intervention for lower back pain:a systematic review. Clin rheumatol, 2013, 32(2):167-180.
35. Rubinstein SM, van Middelkoop M, Assendelft WJ, et al. Spinal manipulative therapy for chronic low-back pain. Cochrane Database Syst Rev, 2011, 2:CD008112.
36. Rubinstein SM, Terwee CB, Assendelft WJ, et al. Spinal manipulative therapy for acute low-back pain. Cochrane Database Syst Rev, 2012, 9:CD008880.
37. Ernst E, Canter PH. Chiropractic spinal manipulation treatment for back pain? A systematic review of randomised clinical trials. Phys Ther Rev, 2003, 8(2):85-91.
38. Huisman PA, Speksnijder CM, De Wijer A. The effect of thoracic spine manipulation on pain and disability in patients with non-specific neck pain:a systematic review. Disabil Rehabil, 2013, 35(20):1677-1685.
39. Kuczynski JJ, Schwieterman B, Columber K, et al. Effectiveness of physical therapist administered spinal manipulation for the treatment of low back pain:a systematic review of the literature. Int J Sports Phys Ther, 2012, 7(6):647.
40. Merepeza A. Effects of spinal manipulation versus therapeutic exercise on adults with chronic low back pain:a literature review. J Can Chir Assoc, 2014, 58(4):456.
41. Mohseni-Bandpei MA, Stephenson R, Richardson B. Spinal manipulation in the treatment of low back pain:a review of the literature with particular emphasis on randomized controlled clinical trials. Phys Ther Rev, 1998, 3(4):185-194.
42. Orrock PJ, Myers SP. Osteopathic intervention in chronic non-specific low back pain:a systematic review. BMC Musculoskelet Disord, 2013, 14(1):129.
43. Licciardone JC, Brimhall AK, King LN. Osteopathic manipulative treatment for low back pain:a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord, 2005, 6(1):43.
44. Franke H, Franke JD, Fryer G. Osteopathic manipulative treatment for nonspecific low back pain:A systematic review and meta-analysis. BMC Musculoskelet Disord, 2014, 15(1):286.
45. Moher D, Tetzlaff J, Tricco AC, et al. Epidemiology and reporting characteristics of systematic reviews. PLoS Med, 2007, 4(3):e78.
46. 李静, 李幼平. 不断完善与发展的Cochrane系统评价. 中国循证医学杂志, 2008, 8(9):742-743.
47. 屈云, 何俐, 刘鸣. Cochrane系统评价的基本方法. 中国临床康复, 2003, 7(4):532.

Chinese Journal of Evidence-Based Medicine

Effectiveness and Safety of Spinal Manipulation for Low Back Pain or Neck Pain:An Overview of Systematic Reviews

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