The review states that the evidence of effectiveness for spinal manipulation is unclear and it does not recommend it as a treatment. American Family Physician (November 2007)

Concludes that a model of care that offered access to a choice of complementary and alternative medicine therapies [acupuncture, chiropractic, or massage therapy] for acute LBP did not result in clinically significant improvements in symptom relief or functional restoration. Spine (January 2007)

"Analysis of the quality and the outcomes of all trials did not provide rigorous evidence that manual therapies have a positive effect in reducing pain from TTH: spinal manipulative therapy showed inconclusive evidence of effectiveness (level 4), whereas soft tissue techniques showed limited evidence (level 3)." Clinical Journal of Pain (March-April 2006)

"…there has only been one randomized clinical trial published in the English language that specifically dealt with the treatment of acute neck pain by manipulation… There has been scant investigative research into the treatment of acute neck pain with chiropractic manipulation." Dept. of Research, Palmer College of Chiropractic West (USA), Journal of Manipulative and Physiological Therapeutics (September 2005)

Concludes: "Physician consultation alone was more cost-effective for both health care use and work absenteeism, and led to equal improvement in disability and health-related quality of life. It seems obvious that encouraging information and advice are major elements for the treatment of patients with cLBP". Spine (15th May 2005)

"The effectiveness of spinal manipulation as a treatment for back pain remains uncertain and controversial. This is because of methodological weakness in many of the published clinical trials and also because of markedly opposing interpretations of the primary data by different reviewers… We conclude that the outcomes of reviews of this subject are strongly influenced by both scientific rigour and profession of authors. The effectiveness of spinal manipulation for back pain is less certain than many reviews suggest; most high quality reviews reach negative conclusions." Canter PH, Ernst E. Wiener Klinische Wochenschrift (The Middle European Journal of Medicine) (May 2005)

Effectiveness of physical treatments for back pain in primary care. Abstract and Rapid Responses. British Medical Journal (November 2004)  [Full text available via free registration]

Concludes that there is currently no evidence to support the use of chiropractic SMT (spinal manipulative therapy) as a primary treatment for asthma or allergy. Balon J W, Mior S A, Dept. of Graduate Studies and Research, Canadian Memorial Chiropractic College, Annals of Allergy, Asthma, & Immunology (August 2004) NOTE: Chiropractic services have recently been delisted by the governments of British Columbia, Ontario, and Alberta.]

"The benefits of spinal manipulation for persistent low back and neck pain have not been convincingly shown to outweigh its risks." D K Weiner, E. Ernst, Clinical Journal of Pain (Jul-Aug 2004)

Specifically states that the evidence does not support the use of chiropractic treatment. Goodyear-Smith F, Arroll B, Annals of Family Medicine (May-June 2004)

Specifically states that a sufficient data base with regard to the benefit of chiropractic medicine is lacking. T. Weiland and K. Wessel, Fortschr Neurol Psychiatr. (June 2004)

The notion that chiropractic or massage are effective interventions for pain control has not been demonstrated convincingly through rigorous clinical trials. E. Ernst, Clinical Journal of Pain (Jan-Feb 2004)

"Manipulative therapy was found in the latest meta-analysis to be slightly more effective than sham therapy (by 4 points on a 100-point scale), but not more effective than other forms of care, including care by a general practitioner, physiotherapy or exercises, 'back school', or therapies known to be ineffective. A contemporary review echoes these findings." Nikolai Bogduk, The Medical Journal of Australia (January 2004)

Journal of Bodywork and Movement Therapies (2004) [pdf]

E. Ernst, Focus on Alternative and Complementary Therapies [F.A.C.T.] (December 2003) [Subscription only]

"In conclusion, the notion that chiropractic spinal manipulation (CSM) is more effective than conventional exercise treatment in the treatment of neck pain was not supported by rigorous trial data." Edzard Ernst, The Journal of Pain (October 2003)

Nikolai Bogduk, MD, The Journal of Pain (October 2003) [This article has recently become subscription-only]

The claim that this approach is effective for such conditions (fibromyalgia, carpal tunnel syndrome, infantile colic, otitis media, dysmenorrhoea and chronic pelvic pain) is not based on data from rigorous clinical trials. Edzard Ernst, New Zealand Medical Journal (August 2003)

Concludes that the effectiveness of chiropractic spinal manipulation is not supported by compelling evidence from the majority of randomised clinical trials. E. Ernst and P. H. Canter, Physical Therapy Reviews (June 2003)

"Almost all of the commonly used diagnostic procedures and passive modalities utilized by chiropractors are not supported in the available literature. Spinal manipulation has mild support in the treatment of acute low back pain, only being equal to or slightly superior to a placebo. The manipulable lesion appears to be hypothetical." Preston Long, PhD., Skeptic Report. Article originally published in the Journal of Quality Health Care (December 2002)