Spinal Manipulation for Older Adults with Chronic Spinal Conditions

Date Posted:

June 2026

Study Title:

Efficacy of spinal manipulative therapy in older adults with chronic spinal conditions: an updated systematic review

Authors:

Schielke AL, Trager RJ, Stevans JM, Price MR, et al.

 

Chronic low back pain and neck pain are common sources of pain, disability, healthcare use, and reduced independence in older adults. Recovery is often slower in this age group, symptoms are more likely to persist, and treatment decisions are complicated by multimorbidity, polypharmacy, frailty, and the fact that many interventions are less well studied in older populations.

Spinal manipulative therapy (SMT) is commonly used for spine pain and is recommended in many guidelines as part of non-surgical, non-pharmacological care. However, older adults are often underrepresented in clinical trials, and previous reviews have suggested that the evidence base specific to this age group remains limited.

This updated systematic review is clinically relevant because it focuses specifically on randomized trials of SMT in older adults with chronic spinal conditions. Rather than asking whether SMT works in general, it asks a more practical question for everyday care: how does SMT compare with other conservative options in older patients with chronic low back pain, neck pain, lumbar spinal stenosis, and related disability?