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"Within hours of the publication of this new US study [Bronfort G, Evans R, Anderson AV, Svendsen KH, Bracha Y, Grimm RH. Spinal manipulation, medication or home exercise with advice for acute and subacute neck pain. A randomised trial. Ann Intern Med 2012; 156:1-10], the world of chiropractic celebrated it as a vindication of chiropractic spinal manipulation. Its aim was to “to determine the relative efficacy of spinal manipulation therapy (SMT), medication, and home exercise with advice (HEA) for acute and subacute neck pain in both the short and long term”. Because neck pain is such a common problem which is often difficult to treat, this study did indeed seem important…At first glance, this seems to be a rigorous piece of research. At closer scrutiny, however, the flaws of this study become fairly obvious…I therefore fear that this study merely shows that TLC and non-specific effects can strongly influence symptoms such as pain. If we consider the high costs of regular SMT versus the negligible expense of HEA, the latter would probably turn out to be preferable. If we finally factor in the potential for harm, the balance decidedly tilts towards HEA. Exercise is virtually risk-free, whereas SMT results in transient adverse effects in about 50% of all patients; in addition, it is associated with several hundred severe complications including deaths." Edzard Ernst, The 21st Floor (1st May 2012)