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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 .
National guidelines vary; some recommend the therapy for those who do not improve with other treatment. [49] It may be effective for lumbar disc herniation with radiculopathy, [50] [51] as effective as mobilization for neck pain, [52] some forms of headache, [53] [54] and some extremity joint conditions.
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Chiropractic authors and researchers Meeker and Haldeman write that the core clinical method that all chiropractors agree upon is spinal manipulation, although chiropractors much prefer to use the term spinal "adjustment", a term which reflects "their belief in the therapeutic and health-enhancing effect of correcting spinal joint abnormalities."
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There is only weak evidence for the effectiveness of the method's use for treating lower back pain. [8] A 2019 systematic review found that there was evidence that it could reduce chronic lower back pain in the short term, and enhance function in the longer term, but that most studies of the treatment had methodological flaws, such as small sample sizes and a lack of blinding.