Manuela L. Ferreira, Paulo H. Ferreira, Jane Latimer, Robert D. Herbert, Paul W. Hodges, Matthew D. Jennings, Christopher G. Maher and Kathryn M. Refshauge
Practice guidelines recommend various types of exercise and manipulative therapy for chronic back pain but there have been few head-to-head comparisons of these interventions. This study compares the effects of general exercise, motor control exercise and manipulative therapy on function and perceived effect of intervention in patients with chronic back pain. Two hundred and forty adults with non-specific low back pain 
3 months were allocated to groups that received 8 weeks of general exercise, motor control exercise or spinal manipulative therapy. General exercise included strengthening, stretching and aerobic exercises. Motor control exercise involved retraining specific trunk muscles using ultrasound feedback. Spinal manipulative therapy included joint mobilization and manipulation. The motor control exercise group had slightly better outcomes than the general exercise group at 8 weeks as did the spinal manipulative therapy group. The groups had similar outcomes at 6 and 12 months. The authors concluded that motor control exercise and spinal manipulative therapy produce slightly better short-term function and perceptions of effect than general exercise, but not better medium or long-term effects, in patients with chronic non-specific back pain.
Pain, 2007, 131(1-2), 31-37.
Link to Abstract
