Annals of Physical and Rehabilitation Medicine, 2026/03, 69(2):102049. doi: https://doi.org/10.1016/j.rehab.2025.102049, type of study: systematic review

Free full text   (https://www.sciencedirect.com/science/article/pii/S1877065725001149)

Keywords:

chronic non-specific low back pain [1]
chronic low back pain [52]
manual therapy [169]
systematic review [445]

Abstract:

Background Chronic nonspecific low back pain (CNLBP) is a widely recognized condition worldwide. Its clinical management must be based on the best current evidence to achieve optimal outcomes, yet there is still a lack of consensus on its clinical approach. Objective To evaluate the effectiveness of manual therapy (MT) on pain intensity, frequency, disability, and quality of life in adults with chronic nonspecific low back pain (CNLBP). Methods A comprehensive search was conducted in 8 databases, covering January 2014 to October 2024. Inclusion criteria included adults with CNLBP, MT interventions provided by healthcare professionals, and systematic reviews (SRs) of randomized controlled trials (RCT). Data on pain intensity, pain frequency, disability, and quality of life measured using validated scales were extracted. The results were shown according to the type of intervention and the period evaluated (short, medium, or long term). Results About 21 SRs with 35,711 participants were included. MT included spinal manipulation, soft-tissue techniques, myofascial techniques, massage, and neuromeningeal techniques. MT outperforms other interventions regarding pain (MD −10.52; 95% CI −13.71 to −7.33) and disability (SMD −0.60; 95% CI−0.80 to −0.40) in the short term, and this effect diminishes over time. Conclusions