Spinal manipulation and mobilization for the treatment of back and neck pain have been the topic of several systematic reviews, with some suggesting that the evidence in support of the view that spinal manipulative therapy is superior to other standard treatments for chronic low back pain is sparse. On the other hand, more recent systematic reviews have reported that spinal manipulation and mobilization are “viable” options for treating pain. Despite this degree of variability among studies, manipulation and mobilization are still considered to be effective treatments when compared with other therapies. The purpose of this systematic review was to unravel these differences and inconsistent findings. 

*Member-Exclusive Content* With the burgeoning opioid epidemic serving as backdrop, the Integrative Health and Wellness Caucus (IHWC) held its inaugural meeting March 15 on Capitol Hill. The Caucus was founded by Reps. Jared Polis (D-Colo.) and Mike Coffman (R-Colo.) with the goal of providing a non-partisan educational forum to increase understanding of how shifting the focus in health care to prevention and health promotion can create cost savings and improve health outcomes for Americans.

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The purpose of this randomized, double-blinded, placebo-controlled, parallel trial was to compare high-velocity low-amplitude spinal manipulation with chemical treatment. In this case, the chemical treatment was diclofenac, a nonsteroidal anti-inflammatory. The trial also included comparison with placebo. Considering the staggering impact of low back pain, the authors of this trial felt there were too few studies comparing spinal manipulation to nonsteroidal anti-inflammatory drugs or placebo. They aimed to test patient satisfaction and function, time off from work, and rescue medication, specifically.

Clinical guidelines for adults with acute, subacute, and chronic low back pain support conservative management with spinal manipulative therapy (SMT). Research shows SMT is comparable to other noninvasive treatments in reducing low back pain and disability with relatively low risk for adverse events. However, the mechanisms leading to pain relief from SMT are poorly understood. Identifying therapeutic mechanisms of SMT can inform treatment strategies and lead to more effective care. 

October is National Chiropractic Health Month, a fitting designation as on Oct. 30, 1972, President Nixon signed into law H.R. 1, the Social Security Amendments of 1972, ending three years of deliberations on what would improve the program. What the president called "landmark legislation" included the significant and far-reaching provision of defining chiropractors as “physicians” in the Medicare program under Sec. 18619(r)(5) of the Social Security Act. Unfortunately, Centers for Medicare & Medicaid Services (CMS) regulators interpreted the law to define the physician status granted to chiropractors in a way that restricted their ability to participate meaningfully, on a level of basic parity.