THE EFFECT OF SPINAL MANIPULATION ON LOWER EXTREMITY RADICULAR PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS

The purpose of the study was to analyze the current body of evidence on SMT as an intervention for pain, disability, and LE neural mobility range of motion (ROM) for individuals with LBP and LE radicular pain.Randomized controlled trials (RCTs) evaluating the effectiveness of spinal manipulation for patients with lower back pain and lower extremity radicular pain were searched using four electronic databases from June to July 2024. The databases searched were EBSCO, Cochrane Library, PubMed, and Google Scholar. Inclusion criteria included: RCT, pilot RTC, or QUASI-experimental studies published 2009-2024 and limited to English language. Additional criteria included radiating symptoms distal to lumbar spine and age >18 years old. Data extraction was carried out by two authors using a customized spreadsheet and discrepancies in the extracted data were reviewed and resolved by the lead author. The following data elements were extracted from the included studies: sample size, age, diagnosis, intervention protocols, control protocols, timeframe, and raw statistical data pertaining to the outcomes of interest. The specific outcomes of interest were self-reported pain, self-reported disability, and lower extremity neural range of motion measurements. For the identified outcomes, the mean and standard deviation (SD) at the final time point after the intervention were extracted for both the intervention group and the control or comparison group. Random-effects meta-analysis was performed, where appropriate, using Comprehensive Meta-Analysis 4.0. The pooled mean difference between the SMT and control groups with 95% confidence intervals (CI) was calculated for all outcomes. Effect size was calculated and measured using Cohen’s d. These data, which will be submitted to ICPSR, fit within the scope of the ICPSR Collection Development Policy. A letter of support describing ICPSR’s commitment to the data as they have been described is provided.