ArticleGeriatric orthopaedic surgery & rehabilitation2014
Spinal Manipulative Therapy for Chronic Lower Back Pain in Older Veterans: A Prospective, Randomized, Placebo-Controlled Trial.
Article in Geriatric orthopaedic surgery & rehabilitation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 7 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Outcome domains of patient-reported outcome measures used in randomised controlled trials for older adults with non-specific low back pain: a systematic review.Age and ageing · 2026Pooled it
- Adverse events among older adults receiving chiropractic spinal manipulation and related treatments: an updated systematic review.Chiropractic & manual therapies · 2026Pooled it
- Efficacy and safety of musculoskeletal manipulations in elderly population with musculoskeletal disorders: a systematic review.BMJ open · 2025Pooled it
- Nonpharmacological Interventions for Chronic Pain in Older Adults: A Systematic Review and Meta-Analysis.The Gerontologist · 2024Pooled it
- Effectiveness of pharmacological and non-pharmacological therapy on pain intensity and disability in older people with chronic nonspecific low back pain: a systematic review with meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Pooled it
- Spinal manipulative therapy in older adults with chronic low back pain: an individual participant data meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Pooled it
- Effects of manual therapies on stability in people with musculoskeletal pain: a systematic review.Chiropractic & manual therapies · 2020Pooled it
- Efficacy of spinal manipulative therapy in older adults with chronic spinal conditions: an updated systematic review.The Journal of the Canadian Chiropractic Association · 2026Article
- The chiropractors' dilemma in caring for older patients with musculoskeletal complaints: Collaborate, integrate, coexist, or separate?PloS one · 2024Article
- Integrated clinical opportunities for training offered through US doctor of chiropractic programs.The Journal of chiropractic education · 2023Article
- Chiropractic Clinical Outcomes Among Older Adult Male Veterans With Chronic Lower Back Pain: A Retrospective Review of Quality-Assurance Data.Journal of chiropractic medicine · 2022Article
- Care Outcomes for Chiropractic Outpatient Veterans (COCOV): a single-arm, pragmatic, pilot trial of multimodal chiropractic care for U.S. veterans with chronic low back pain.Pilot and feasibility studies · 2022Article
- Care Outcomes for Chiropractic Outpatient Veterans (COCOV): a qualitative study with veteran stakeholders from a pilot trial of multimodal chiropractic care.Pilot and feasibility studies · 2022Article
- Symptoms patients receiving manual therapy experienced and perceived as adverse: a secondary analysis of a survey of patients' perceptions of what constitutes an adverse response.The Journal of manual & manipulative therapy · 2021Article
- Chiropractic and Spinal Manipulation Therapy on Twitter: Case Study Examining the Presence of Critiques and Debates.JMIR public health and surveillance · 2016Article
- Evaluation of a modified clinical prediction rule for use with spinal manipulative therapy in patients with chronic low back pain: a randomized clinical trial.Chiropractic & manual therapies · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionChronic lower back pain (CLBP) is problematic in older veterans. Spinal manipulative therapy (SMT) is commonly utilized for CLBP in older adults, yet there are few randomized placebo-controlled trials evaluating SMT.
methodsThe purpose of the study was to compare the effectiveness of SMT to a sham intervention on pain (Visual Analogue Scale, SF-36 pain subscale), disability (Oswestry Disability Index), and physical function (SF-36 subscale, Timed Up and Go) by performing a randomized placebo-controlled trial at 2 Veteran Affairs Clinics.
resultsOlder veterans (≥ 65 years of age) who were naive to chiropractic were recruited. A total of 136 were included in the study with 69 being randomly assigned to SMT and 67 to sham intervention. Patients were treated 2 times per week for 4 weeks assessing outcomes at baseline, 5, and 12 weeks postbaseline. Both groups demonstrated significant decrease in pain and disability at 5 and 12 weeks. At 12 weeks, there was no significant difference in pain and a statistically significant decline in disability scores in the SMT group when compared to the sham intervention group. There were no significant differences in adverse events between the groups.
conclusionsThe SMT did not result in greater improvement in pain when compared to our sham intervention; however, SMT did demonstrate a slightly greater improvement in disability at 12 weeks. The fact that patients in both groups showed improvements suggests the presence of a nonspecific therapeutic effect.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.