While spinal stiffness is thought to be an important factor in the diagnosis and management of various spinal conditions, it is notoriously difficult to measure directly. As a result, clinicians often rely on posteroanterior palpation to estimate bulk stiffness as a proxy for the stiffness of internal spinal tissues. Unfortunately, the validity of this proxy remains uncertain. To investigate this, we posed two key research questions: (1) How do measurements of bulk stiffness correlate with direct measures of spinal stiffness? and (2) Can bulk stiffness measurements be normalized to more accurately reflect internal spinal stiffness?

Literature on low back pain (LBP) treatment suggests not all LBP is the same and patients with extension- or flexion-related LBP may benefit from different strategies. This study's objective was to evaluate the effect of participant positioning when delivering spinal manipulation on reported immediate comfort, in individuals with LBP.

Understanding the factors influencing surgical decisions specific to symptomatic lumbar spinal stenosis (SLSS) can help healthcare providers support patients, set expectations and improve health literacy. Therefore, the purpose of this study is to explore the experiences and perspectives of Canadian patients who choose to undergo surgery for SLSS.

Chiropractors are trained to help others, but do chiropractors need help themselves? While many health professions have been surveyed regarding their mental health and wellness, no such comprehensive survey has been conducted in the chiropractic profession. These data are important to improve the health of individual chiropractors, designing effective interventions and creating a strategic workforce plan.

Low back pain (LBP) is increasingly common among adolescents, yet little is known about the healthcare utilization in this population. We aimed to describe the characteristics and treatment patterns of adolescents with LBP presenting to a specialized comprehensive pediatric health system.

To comprehensively map the literature on the use of manual therapy (MT) in the management of traumatic brain injury (TBI).

Veteran Response to Dosage in Chiropractic Therapy (VERDICT) was a pragmatic randomized trial testing chiropractic dosage effects in 766 veterans with chronic low back pain (CLBP) of ≥ 3 months. This cross-sectional analysis compares baseline characteristics of younger (18-to-64 years) and older veterans (≥ 65 years).

A comprehensive description of the profile of chiropractic practices and services provided can help guide curriculum design, inform quality improvement and guideline initiatives, and facilitate workforce planning. This cross-sectional study aimed to describe the sociodemographic characteristics, professional activities, work organization, clinical practice patterns, and interprofessional referrals of chiropractors in France.

Low back pain (LBP) is one of the most disabling conditions in older adults and among the costliest in terms of healthcare expenditures. Many factors contribute to the disability and high costs of LBP in older adults, but one of the most preventable is the spread of misinformation and unhelpful attitudes, beliefs, and behaviors. These are often perpetuated by family, friends, social media, pharmaceutical companies, other industries, and healthcare providers. Myths about back pain foster false attitudes, beliefs, and behaviors that lead to inappropriate, costly, and sometimes harmful treatments. Such myths can result in psychological consequences, including fear of movement, poor self-efficacy, low motivation, anxiety, stress, and depression- all of which further perpetuate disability. Injections, surgeries, and medications for non-specific LBP are usually ineffective and are associated with significant side effects in older adults. The purpose of this paper is to dispel ten common myths of LBP in older adults, with the goals of changing attitudes, beliefs, and behaviors to reflect a more positive and evidence-based approach among practitioners and public. The aim is also to motivate practitioners to educate their older patients based on the best available evidence. This can improve outcomes, reduce costs, reduce disability, and improve quality of life among older adults with back pain.

Suicide remains a major cause of preventable death worldwide. A recent guidance document from NHS England (Staying Safe from Suicide, 2025) highlights the limitations of traditional suicide risk prediction methods and advocates for a relational, person-centred approach. While not mental health specialists, chiropractors and osteopaths often work closely with individuals facing musculoskeletal chronic pain, disability, financial stress, and social isolation, all of which are risk factors for psychological distress. This commentary explores how the NHS guidance offers key lessons for chiropractic and osteopathic practice. Valuable contributions to suicide prevention efforts can be made by fostering strong therapeutic relationships, adopting a biopsychosocial view of health, and encouraging help-seeking behaviours where needed. Through small, relational actions, practitioners can support patient wellbeing while working within the boundaries of their professional scope of practice.

Patient-centred care (PCC) is considered an essential concept in twentyfirst-century healthcare; however, health care providers' attitudes can be an important barrier or facilitator to its actual implementation. Chiropractic is frequently referred to as providing PCC. However, the attitudes of practising chiropractors towards patient-centred care have not previously been evaluated.

Musculoskeletal (MSK) pain affects quality of life and burdens healthcare systems, increasing the need for effective self-management tools. Mobile health apps offer a potential solution, but their adoption in clinical practice remains limited due to concerns about usability, patient engagement, and data security. Denmark is highly digitalized, with various digital health initiatives already in place. However, little is known about chiropractors' engagement with health apps. This study examines how Danish chiropractors utilize and perceive health apps in their practice, identifying key barriers and facilitators to adoption and providing insights for broader implementation in primary care settings to improve self-management support for patients with MSK pain.

Clinical guidelines for managing non-specific spine pain recommend providing patient education and self-management support strategies (SMSS) as first-line treatment. However, SMSS implementation in daily chiropractic care remains challenging. This study aimed to assess the level of patient activation in their care, explore chiropractic senior interns and clinician supervisors' beliefs about evidence-based practice (EBP) and self-management support, and identify theoretical barriers and facilitators to implementing SMSS.

Various analgesics are frequently prescribed by physicians and used by patients with low back pain (LBP) despite limited effect on pain and disability and risk of side effects. Current knowledge on how psychological measures and self-management interventions influence analgesic use is limited. We investigated if analgesic use changed after participating in a patient education and exercise therapy program (GLA:D® Back), to what extent analgesic use and self-efficacy at baseline were potential determinants of analgesic use at the end of the program, and, to what extent improvement in self-efficacy from before to after the intervention modified the relationship between analgesic use at baseline and follow-up.

Cervical neural tension reflects the biomechanical and physiological responses of spinal nerves to positional changes. Although clinical tests exist for the lower cervical spinal nerve, tension patterns in the upper and mid-cervical nerves remain underexplored, limiting the diagnostic accuracy for conditions such as occipital neuralgia.

A proactive patient safety culture is crucial in healthcare to minimize preventable harm and improve patient outcomes. This scoping review explores key themes, trends, and gaps in patient safety culture research within the chiropractic profession.

Neck pain and headaches often co-occur, and the presence of degenerative cervical Magnetic Resonance Imaging (MRI) findings has been associated with the presence of headaches. However, previous studies have not provided conclusive evidence about their association, and imaging studies examining the associations between headache severity and MRI findings have been suggested. This study aims to investigate the associations between independent variables, single MRI findings, and an aggregate score of MRI findings, and the outcome variable, headache severity.

Frailty and low back pain (LBP) may negatively affect each other in older adults, yet no systematic review has summarized their cross-sectional, temporal, or causal associations. Exploring these associations could provide valuable insights for reducing frailty risk in older adults with LBP. This systematic review aimed to consolidate evidence on the association between frailty and LBP in older adults.

This study reviews the 20-year history (2005-2025) of Chiropractic & Manual Therapies as an open-access, peer-reviewed journal. Originally launched in 1992 as COMSIG Review, the journal has undergone multiple title changes and is currently financially supported by three chiropractic societies. This review critically examines 20 years (2005-2025) as an open-access online journal and makes recommendations for future growth.