– Giles and Muller (JMPT 2005) in a long-term follow up of a randomized clinical trial assess the long-term benefits of medication, needle acupuncture, and spinal manipulation as treatment regimens in patients with chronic (>13 weeks) spinal pain syndromes.

Conclusions: In patients with chronic spinal pain syndromes, spinal manipulation, if not contraindicated, may be the only treatment modality of the assessed regimens that provides broad and significant long-term benefit.

– Aure OF et al. (2003) compared the effectiveness of manual therapy (either manipulation or mobilization) to exercise therapy in patients with chronic low back pain of a duration greater than 8 weeks. They conclude that, “Improvements were found in both intervention groups, but manual therapy showed significantly greater improvements than exercise therapy in patients with chronic low back pain. The effects were reflected on all outcome measures, both on short and long term follow up”.

– Van Tulder, Koes, and Bouter (1997), researchers in the Netherlands funded by the Dutch Health Insurance Board, retrieved and evaluated evidence from 48 randomized controlled trials conducted worldwide that addressed the treatment of acute and chronic low back pain. Researchers found “strong evidence” for the effectiveness of spinal manipulation in the treatment of chronic low back pain. “There is strong evidence that manipulation is more effective than a placebo treatment for chronic low-back pain or than usual care by the general practitioner, bed rest, analgesics and massage.”

References:
Aure OF, Nilsen JH, Vasseljen O, “Manual therapy and exercise in patients with chronic low back pain: A randomized, controlled trial with 1-year follow-up”. Spine. 2003 Mar15;28(6):525-31.
Giles LG, Muller R, “Chronic Spinal Pain: A randomized clinical trial comparing medication, acupuncture, and spinal manipulation”. Spine. 2003 Jul 15;28(14):1490-502.
Van Tulder, Maurits W., Bart W. Koes, and Lex M. Bouter. 1997. “Conservative Treatmentof Acute and Chronic Nonspecific Low Back Pain: A Systematic Review of Randomized Controlled Trails of the Most Common Interventions.” Spine 22, no. 18: 2128-2156.