Table 2.

Effectiveness and efficacy (compared to inactive controls) of spinal manipulative therapy (SMT) for the management of low back pain (LBP).

Comparisons studied	Conclusions from previous studies
SMT vs. inactive control	Insufficient evidence for SMT when compared to sham treatmenta−j
SMT vs. mobilization	Evidence supporting that SMT and mobilization are equally effectivek−n
SMT vs. standard medical care	Inconsistent evidence, only for acute LBP, could depend on doseo−r
SMT vs. physical therapy	Evidence supporting that SMT adds value to and is at least as effective as physical therapy for chronic LBP and leg pains−w
SMT vs. exercise	Evidence supporting SMT being as effective as exercise; stronger evidence for chronic LBPn, r, x−z
Guidelines' recommendations	For acute and chronic LBP with or without leg pain, SMT is recommended aloneaa−ac or more often as part of multimodal care along with advice, education, reassurance and exercicead−ai.

^aSenna and Machaly. (88).

^bvon Heymann et al. (89).

^cBialosky et al. (90).

^dBialosky et al. (90).

^eVieira-Pellenz et al. (92).

^fThomas et al. (93).

^hScholten-Peeters et al. (107).

^hRuddock et al. (108).

ⁱGianola et al. (109).

^jLavazza et al. (110).

^kHondras et al. (94).

^lCook et al. (95).

^mXia et al. (96).

ⁿRubinstein et al. (60).

^oJuni et al. (79).

^pGoertz et al. (83).

^qSchneider et al. (85).

^rPaige et al. (98).

^sCecchi et al. (80).

^tBronfort et al. (84).

^uNambi et al. (86).

^vGhasabmahaleh et al. (87).

^wGoertz et al. (105).

^xBronfort et al. (81).

^yHidalgo et al. (99).

^zCoulter et al. (97).

^aaChou et al. (111).

^abQaseem et al. (17).

^acKirkwood et al. (15).

^adDagenais et al. (112).

^aeBernstein et al. (113).

^afWong et al. (114).

^agBussieres et al. (115).

^ahStochkendahl et al. (116).

^aiBailly et al. (19).