Although there are several studies that indicate that physiotherapy spinal manipulation may be beneficial in the short term, the study design and evidence of these studies do not permit valid conclusions. This is also the case for scientific evidence of chiropractic manipulation for low back pain. Although there are several studies that suggest that mobilization and manipulation have positive results in the treatment of low back pain. Physiotherapists are qualified to comprehensively assess, make a physical diagnosis, plan and implement treatment without a medical referral. This is based on a 4 year university and clinical education program that provides a unique body of knowledge and skills in all areas including the treatment of low back pain and other problems.
Spinal manipulation is within the scope of practice of physiotherapists.
Development of advanced skills in this area is built on core physiotherapy competencies. An approach, formally recognized by the Association. is to participate in a rigorous post graduate education program followed by competency-based examinations. This process is recognized nationally and internationally. Physiotherapists believe that chiropractors provide safe treatment for patients with specific problems. They commonly use spinal manipulation for low back pain, but also use modalities of heat.