A recent meta-study looked at spinal manipulation for back pain as well as shoulder and other NMS conditions. Beginning with 1,243 studies they focused on 25 studies that examined the economics of manipulation and manual therapy.
Their conclusion found “some economic advantage of manual therapy relative to other interventions used for the management of musculoskeletal conditions.” They also concluded that more study is strongly needed.
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Tsertsvadze, A., Clar, C., Court, R., Clarke, A., Mistry, H., & Sutcliffe, P. (2014 Jan 16). Cost-Effectiveness of manual therapy for the management of musculoskeletal conditions: A systematic review and narrative synthesis of evidence from randomized controlled trials. Journal of Manipulative and Physiological Therapeutics. Retrieved from http://www.jmptonline.org/article/S0161-4754(14)00087-6/abstract