Overviews and Systematic Reviews on Low Back Pain
Authors: Edzard Ernst
Journal: Annals of Internal Medicine (2008)

Letters20 May 2008Overviews and Systematic Reviews on Low Back PainEdzard Ernst, MD, PhDEdzard Ernst, MD, PhDFrom Peninsula Medical School, Universities of Exeter and Plymouth, Exeter EX2 4NT, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-10-200805200-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their recent overview on low back pain, Chou and Huffman (1) cite 2 of our reviews (2, 3), stating that these and 3 other assessments “consistently found that serious adverse events after spinal manipulation (such as worsening lumber disc herniation or the cauda equina syndrome) were very rare.” Yet 1 of these reviews (2) concludes that “the available data suggest that mild to moderate, transient adverse reactions occur in about 50% of patients after chiropractic spinal manipulation. Serious injuries are probably much rarer, but more conclusive studies are urgently needed.” The other (3) states that “serious ...References1. Chou R, Huffman LH. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med. 2007;147:492-504. [PMID: 17909210] LinkGoogle Scholar2. Ernst E. Prospective investigations into the safety of spinal manipulation. J Pain Symptom Manage. 2001;21:238-42. [PMID: 11239743] CrossrefMedlineGoogle Scholar3. Stevinson C, Ernst E. Risks associated with spinal manipulation. Am J Med. 2002;112:566-71. [PMID: 12015249] CrossrefMedlineGoogle Scholar4. Ernst E. Adverse effects of spinal manipulation: a systematic review. J R Soc Med. 2007;100:330-8. [PMID: 17606755] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Peninsula Medical School, Universities of Exeter and Plymouth, Exeter EX2 4NT, United Kingdom.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDiagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society Roger Chou , Amir Qaseem , Vincenza Snow , Donald Casey , J. Thomas Cross Jr , Paul Shekelle , Douglas K. Owens , and Nonpharmacologic Therapies for Acute and Chronic Low Back Pain: A Review of the Evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline Roger Chou and Laurie Hoyt Huffman Medications for Acute and Chronic Low Back Pain: A Review of the Evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline Roger Chou and Laurie Hoyt Huffman Overviews and Systematic Reviews on Low Back Pain Roger Chou , Paul Shekelle , Amir Qaseem , and Douglas K. Owens Overviews and Systematic Reviews on Low Back Pain Jan M. Bjordal , Atle Klovning , Rodrigo Alvaro B. Lopes-Martins , Pål-Didrik Hoff Roland , Jon Joensen , and Lars Slørdal Metrics Cited ByThe Science and Art of Deduction: Complex Systematic OverviewsJohn E. Cornell, PhD, Associate Editor and Christine Laine, MD, MPH, Senior Deputy Editor 20 May 2008Volume 148, Issue 10Page: 790-791KeywordsAdverse eventsAdverse reactionsChiropracticConflicts of interestLower back painSpineStrokeSystematic reviews ePublished: 20 May 2008 Issue Published: 20 May 2008 CopyrightCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...