BMJ  2004;329 (11 December), doi:10.1136/bmj.329.7479.0-c

Spinal manipulation gives value for money

Most patients with acute back pain improve over time, but adding spinal manipulation followed by exercise to standard care moderately improves results. The UK BEAM trial team (p 1377) randomised 1334 patients with low back pain to additional exercise classes, spinal manipulation, or manipulation followed by exercise or to "best care" in general practice. Manipulation, with or without exercise, improved symptoms more than best care alone after three and 12 months. However, analysis of the cost utility of different strategies shows that manipulation alone probably gives better value for money than manipulation followed by exercise (p 1381).

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