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Spinal manipulation appears to provide similar effects to other recommended treatments for chronic low back pain. [57] There is no evidence it is more effective than other therapies or sham, or as an adjunct to other treatments, for acute low back pain [58] "Back school" is an intervention that consists of both education and physical exercises.
The WFEs were for many years the standard for non-surgical low back pain treatment. [citation needed] These exercises were performed in the supine position on a floor or other flat surface. There were variations, but the primary maneuver is to grab the legs and pull the knees up to the chest and hold them there for several seconds.
In 1992, chiropractors were estimated to perform over 90% of all manipulative treatments given for low back pain treatment in the USA. [48] A 2012 survey in the US found that 99% of the first-professional physical therapy programs that responded were teaching some form of thrust joint manipulation. [49]