Spinal manipulative therapy (SMT) has few benefits for patients with chronic low-back pain, according to a special review in a recent issue of Spine. Researchers at Vrije Universiteit Medical Center in Amsterdam, Holland, reviewed data from 26 clinical trials that included more than 6,000 patients. In all studies, patents were randomly assigned to SMT or some other form of active treatment-exercise or physical therapy-or an inactive placebo. The studies included any type of hands-on spinal treatment, most commonly delivered by chiropractors, physical therapists, and osteopaths. Chronic low-back pain was defined as pain lasting longer than 12 weeks.