Chiropractors in the UK are regulated by the General Chiropractic Council, and the advertising rules (the CAP Code) set out which problems chiropractors can say they help with. This page lists published research and guidelines for those problems, newest first. Each summary says what the authors concluded; follow the links to read the sources in full.
Back pain and lumbago
NICE, which writes the national health guidance for England, recommends considering manual therapy (spinal manipulation, mobilisation or soft tissue techniques such as massage) for low back pain, as part of a treatment package that includes exercise.
A 2026 umbrella review, bringing together 21 systematic reviews with 35,711 people, found manual therapy gave significant short-term reductions in pain and disability for long-standing low back pain.
A 2026 review found that adding manual therapy to exercise improved disability (how much back pain limits daily life) more than exercise alone, in both the short and the long term.
A 2025 review of 10 studies found that manual therapy added to exercise improved short-term pain, function and disability more than exercise alone, and recommended adding it.
The World Health Organization's 2023 guideline on long-standing low back pain lists spinal manipulative therapy among the treatments that may be used for adults, alongside other non-drug care such as exercise and education.
A review of 47 trials with 9,211 people, published in the BMJ, found spinal manipulation had similar effects to other recommended treatments for long-standing low back pain, and improved function more than non-recommended treatments in the short term.
A review of trials published in JAMA found spinal manipulation was linked to modest improvements in pain and function for recent (acute) low back pain, at up to 6 weeks.
The American College of Physicians lists spinal manipulation among the non-drug treatments to choose first, for both recent and long-standing low back pain.
The UK evidence report, a review of the trials and guidelines on manual therapy, concluded that spinal manipulation and mobilisation are effective in adults for acute, subacute and chronic (long-standing) low back pain.
Read about back pain and lumbago
Mechanical neck pain
A 2025 review of 8 trials with 965 people found spinal manipulation reduced pain and disability and improved neck movement in recent (acute) neck pain, with no serious side effects reported.
A 2025 review of 11 trials concluded that manual therapy and exercise may be considered effective for reducing long-standing neck pain, and that combining them was the most likely best choice.
Guidelines built from 41 good-quality trials made strong recommendations for manipulation, manual therapy and exercise, combined with other care, for long-standing neck pain, and moderate recommendations for manipulation and mobilisation, combined with other care, for recent neck pain.
In a trial of 272 adults with recent neck pain, spinal manipulation gave better pain results than medication, in both the short and the long term. A few sessions of home exercise with advice gave similar results, which is why Ismail adds exercises to your care.
The UK evidence report concluded that manipulation and mobilisation of the upper back are effective for recent neck pain, and that massage is effective for long-standing neck pain.
Read about mechanical neck pain
Sciatica
NICE recommends considering manual therapy (spinal manipulation, mobilisation or soft tissue techniques such as massage) for low back pain with or without sciatica, as part of a treatment package that includes exercise. The guideline was last updated in July 2026.
In a 2021 trial of 44 people with leg pain from an irritated nerve in the lower back (lumbar radiculopathy), adding 3 sessions of spinal manipulation to physiotherapy gave better results over 3 months than physiotherapy alone.
In a trial of 192 adults with leg pain coming from the back, spinal manipulation plus home exercise and advice reduced leg pain more than home exercise and advice alone at 12 weeks. At one year, the people who had manipulation still reported more overall improvement and satisfaction, and used less medication.
Headaches arising from the neck, and migraine prevention
A 2025 review of 14 studies with 1,297 people with headaches arising from the neck found that a mobilisation technique (sustained natural apophyseal glides) improved pain and function, with benefits maintained over time, and that neck manipulation may be the most effective short-term option for pain and disability.
A 2020 review of 7 trials found spinal manipulation gave small short-term benefits for the intensity and frequency of headaches arising from the neck, and for disability.
A 2019 review of 6 trials with 677 people found spinal manipulation may reduce the number of migraine days and migraine pain.
An update of the UK evidence report, from the University of Warwick, raised the evidence for spinal mobilisation for headaches arising from the neck from inconclusive to moderate.
Evidence-based guidelines for chiropractors recommend spinal manipulation for headaches arising from the neck (cervicogenic headache), and spinal manipulation and care including massage for people with episodic or chronic migraine.
The UK evidence report concluded that spinal manipulation and mobilisation are effective in adults for migraine and for headaches arising from the neck (cervicogenic headache).
Read about headaches arising from the neck, and migraine prevention
Shoulder pain and rotator cuff injuries
A 2026 review of 19 trials with 956 people found that adding joint mobilisation to usual physiotherapy reduced pain and improved movement and function in the short term for shoulder impingement (shoulder pain when lifting the arm).
A 2025 review found that adding mobilisation (the Mulligan technique) to usual care improved pain, function and shoulder movement in rotator cuff problems, compared with usual care alone.
A 2025 review of 7 trials with 393 people found manual therapy to the upper back, alone or with exercise, reduced pain and disability in subacromial pain syndrome, a common cause of shoulder pain, especially in the short term.
An update of the UK evidence report, from the University of Warwick, raised the evidence for manipulation and mobilisation, with exercise, for rotator cuff disorders from inconclusive to moderate.
A systematic review found fair evidence for manual therapy to the shoulder and the areas linked to it, combined with exercise or other care, for rotator cuff injuries and disorders, and for shoulder pain and dysfunction.
Read about shoulder pain and rotator cuff injuries
Hip and knee pain from osteoarthritis
A 2026 review of 23 trials with 996 people found mobilisation with movement reduced pain and disability in knee osteoarthritis, with bigger effects when it was combined with other therapies.
A 2024 review of 25 studies with 2,376 people found manual therapy may reduce knee osteoarthritis pain, more so after 4 weeks of treatment, and appears to be safe.
NICE recommends that manual therapy (such as manipulation, mobilisation or soft tissue techniques) is considered for hip or knee osteoarthritis only alongside therapeutic exercise, not on its own.
A review of manual therapy for leg and foot problems, which assessed 48 clinical trials, found fair evidence for manual therapy in the short-term treatment of hip and knee osteoarthritis.
Read about hip and knee pain from osteoarthritis
Minor sports injuries
A 2025 review of 10 trials with 419 people found mobilisation with movement reduced pain and improved ankle movement and balance after ankle sprains.
A 2025 review found that adding mobilisation (the Mulligan technique) to usual care improved pain, function and shoulder movement in rotator cuff problems, compared with usual care alone.
A 2022 analysis of 3 trials with 180 people found manual therapy plus exercise improved pain, ankle movement and leg function more than exercise alone after an ankle sprain.
A review of manual therapy for leg and foot problems found fair evidence for manual therapy in the short-term treatment of ankle inversion sprains (rolling the ankle inwards).
The UK evidence report concluded that manipulation and mobilisation are effective for several arm and leg joint conditions.
Read about minor sports injuries
Plantar fasciitis and ankle sprains (short-term management)
A 2026 review of 11 trials found soft tissue manual therapy, especially combined with usual care such as stretching and strengthening, improved pain and foot function in long-standing plantar fasciitis more than usual care alone. Instrument-assisted soft tissue work and myofascial release gave consistent improvements.
A 2025 review of 10 trials with 419 people found mobilisation with movement reduced pain and improved ankle movement and balance after ankle sprains.
A 2022 analysis of 3 trials with 180 people found manual therapy plus exercise improved pain, ankle movement and leg function more than exercise alone after an ankle sprain.
A review of manual therapy for leg and foot problems, which assessed 48 clinical trials, found fair evidence for manual therapy in the short-term treatment of plantar fasciitis and of ankle inversion sprains.
The UK evidence report concluded that manipulation and mobilisation are effective for several arm and leg joint conditions.
Read about plantar fasciitis and ankle sprains
Checked by Dr Ismail Hassan, Doctor of Chiropractic (GCC 06577), October 2026.