Best practices for chiropractic management of adult patients with mechanical low back pain: a clinical practice guideline for chiropractors in the United States

This guideline updates the 2016 best-practice recommendations for how US chiropractors should manage adults with mechanical low back pain. It was written by a steering committee of chiropractic researchers, educators and clinicians and appears in the Journal of Manipulative and Physiological Therapeutics.

Health librarians searched the literature from 2015 to 2021 for guidelines and other evidence, and the steering committee used the newest guidelines and studies to revise the recommendations. A large expert panel then rated the statements in a modified Delphi process, and all of them reached consensus by the second round.

The recommendations cover the whole visit: history, physical examination, diagnostic considerations, informed consent, co-management and treatment. Its main conclusion favors conservative care built on active treatment combined with multimodal care, with spinal manipulation as one part of that care.

Summarized from the published abstract; the full text was not open to us.