Low back pain and neck pain remain the most common reasons patients week care from both their primary care physician and Physical Therapist. Research has supported the short term utilization of spinal manipulation for patients with spinal pain to reduce pain and disability. In our Boulder Physical Therapy and Lafayette Physical Therapy practices we utilize spinal manipulation combined with targeted high level exercise in order get patients back to the activities they enjoy. Authors continue to report the targeted level of the manipulation (painful vs. non painful, PT selected or randomly selected) do not seem to influence the effectiveness of the technique. A large review of the medical evidence was published to determine the impact of this specificity.
Nim and colleagues published their findings in the Journal of Orthopedic and Sports Physical Therapy (2025). Their article included almost 12,000 participants from 161 randomized, controlled trials on the effects of manipulation specificity. Authors found the vertebral level, type of manipulation, and painful vs. non painful vertebral joints did not influence pain and disability outcomes. Further, they reported the greatest chances of success with the intervention were found when treatments were general vs specific in nature. They concluded the effectiveness of these treatments does not depend on the application procedure.
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