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A 2010 report issued by the Agency for Healthcare Research and Quality found spinal manipulation is as effective as medication for low back pain. The same year, a British analysis of nearly 100 high-quality systematic reviews and randomized controlled trials found that manipulation was beneficial for acute and chronic low back pain, neck pain and knee OA. But people with active inflammation, a fused spine or osteoporosis in the spine or neck, shouldn't be treated with chiropractic therapy.