Abstract: Chiropractors are primary care providers for spinal and musculoskeletal conditions. Current literature recognises the evidence for benefits of common musculoskeletal complaints including back and neck pain, a minority of patient visits are non-musculoskeletal in nature. The hypothesis that spinal manipulative therapy does have an effect on the patient beyond muscle and joint pain is a claim that has been scrutinised inside and outside the profession possibly due to the absence of high level evidence to support those claims. Electronic databases were searched using Mesh terms and selection criteria was met. The search yielded 23 papers, the literature was evaluated using selective critical appraisal tools. Of those, ten were randomised controlled trials, nine were systematic reviews, one was a cohort study and three were surveys. Four papers were evaluated as no evidence, 14 were evaluated as inconclusive, four papers had conclusive evidence and there was a moderate to low range of bias across all papers. The claim that SMT can affect the patient beyond muscle and joint pain cannot be substantiated due to the methodological bias and inconclusive evidence of the current literature. Improvements for future evidence quality may increase with better objective outcome measures, specified topics of research, double-blinding in randomised controlled trials and more controlled cohort studies to improve reproducibility.

Indexing Terms: Spinal manipulative therapy, non-musculoskeletal, evidence, chiropractic

Cite: McDowall C-A. Evidence that may support the claim that spinal manipulative therapy can affect the patient beyond muscle and joint pain: A systematic narrative review. Asia-Pac Chiropr J. 2021;1.3.URL apcj.net/mcdowall-review/