Physical Therapy Modalities: No Evidence of Benefit for Back Pain Despite Wide Use

Physical Therapy Modalities: No Evidence of Benefit for Back Pain Despite Wide Use: Chiropractic Adjustment/SMT Has Always Been Most Effective


A Natural Connection

August 2020

© The Wellness Practice © Dr. James L. Chestnut M.Sc, D.C., C.C.W.P.

Young man with back pain
Man With Back Pain


"At this time, the evidence from the small number of placebo-controlled trials does not support the use of TENS in the routine management of chronic LBP."

"Interferential current alone was not significantly better than placebo or other therapy at discharge or follow-up."

"The available evidence does not support the effectiveness of ultrasound or shock wave for treating LBP."

"The efficacy of low-level laser treatment (LLLT) for chronic back pain remains controversial due to insufficient trial data."

"In summary, recent studies have shown that thrust manipulation in subgroups of patients with LBP provides superior outcomes in pain and function, as well as reduced health care costs.” “Therefore, we call upon entry-level physical therapy programs in Canada to increase curricular content with regard to instruction in spinal thrust manipulation and thereby allow new graduates to provide best practice for patients with spinal impairments."

Chiropractic Adjustment, Dr Nathan Jenner, Chiropractor Prahran Windsor
Chiropractic Adjustment

Key Concepts:

The evidence just keeps piling up in favour of chiropractic adjustment/SMT and against every other alternative whether it be physiotherapy, drugs, surgery, or any other alternative treatment.

Treatments that have been marketed and utilised for decades never had a shred of evidence of effectiveness compared to chiropractic yet these interventions have been falsely advertised as being more evidence-based and more effective than chiropractic.

Key Take Home Points:

Trust the evidence. Trust evidence-based healthcare providers that offer evidence-based interventions. Trust your chiropractor!


Poitras & Brosseau (2008). Evidence-informed management of chronic low back pain with transcutaneous electrical nerve stimulation, interferential current, electrical muscle stimulation, ultrasound, and thermotherapy. The Spine Journal 8(1): 226-233

Fuentes, J, et al. Effectiveness of Interferential Current Therapy in the Management of Musculoskeletal Pain: A Systematic Review and Meta-Analysis. Physical Therapy 2010 90(9):1219-38

Binny, J. et al. Transcutaneous Electric Nerve Stimulation (TENS) for Acute Low Back Pain: Systematic Review. Scand J Pain 2019 19(2):225-233

Ebadi, S. et al. Therapeutic ultrasound for chronic low back pain (Review). Cochrane Database of Systematic Reviews. 2020 Issue 7. Art. No.: CD009169.

Glazov G, Yelland M, Emery J. Low-level laser therapy for chronic non-specific low back pain: a meta-analysis of randomized controlled trials. Acupunct Med 2016;34:328–341.

Huijbregts et al. (2007). Adding Spinal Thrust Manipulation to Entry-Level Canadian Physical Therapy Curricula: Why and How? Physiotherapy Canada 59(1): 1-4


Brought to you by: Dr Nathan's Chiropractic Studio

Phone: 0400041976



Dr Nathan Jenner is a Chiropractor with 21 years experience helping patients with back pain, disc injuries, sciatica and back pain related issues. His practice in Windsor, Victoria, 3181, serving patients in the Windsor, Prahran, South Yarra and St Kilda are of inner south-east Melbourne. If you are suffering from back or leg pain why not call 0400041976 to arrange a time or email or contact me if you have further questions.

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