Rubinstein SM, et al. - For the treatment of chronic low back pain, researchers evaluated the benefits and harms of spinal manipulative therapy (SMT). Studies were considered eligible if they included adults (≥18 years) and if pain lasted more than three months for more than 50% of the study population. Studies that examined sciatica exclusively, like grey literature, were excluded. Forty-seven randomized controlled trials were identified, including a total of 9211 participants who were medium age (35-60 years) on average. According to this systematic review and meta-analysis of randomised controlled trials, SMT produces similar effects to recommended therapies for chronic low back pain, while SMT appears to be better for improving function in the short term than non-recommended interventions. Clinicians should inform their patients about the potential risks of SMT-related adverse events. Musculoskeletal-related, transient in nature, and of mild to moderate severity were most of the observed adverse events.