Treatment group Mean cost* (£) Mean adjusted QALYs* Incremental cost effectiveness ratio to nearest £100 or comment Excluding participants with health care costing more than £2000 over 12 months (n=1266) Best care in general practice 277 0.621 Best care plus exercise 322 0.632 Subject to extended dominance by manipulation Best care plus manipulation and exercise 403 0.647 Subject to extended dominance by manipulation Best care plus manipulation 411 0.665 £3000 relative to best care NHS provides manipulation for only 50% of patients (n=1287) Best care in general practice 346 0.616 Best care plus exercise 486 0.628 Subject to extended dominance by manipulation and exercise Best care plus manipulation and exercise 537 0.645 £6600 relative to best care Best care plus manipulation 624 0.655 £8700 relative to manipulation and exercise Manipulation provided only in private premises (n=1287) Best care in general practice 346 0.616 Best care plus exercise 486 0.628 Subject to extended dominance by manipulation and exercise Best care plus manipulation and exercise 595 0.645 £8600 relative to best care Best care plus manipulation 701 0.655 £10 600 relative to manipulation and exercise

QALY=quality adjusted life year.

^* Markov Chain Monte Carlo estimates from bivariate hierarchical multilevel model.

Estimated by analysis of covariance with adjustment for baseline EQ-5D score and then rounded to three significant figures.