STUDY DESIGN: Randomized controlled trial. OBJECTIVE: The determine the short-term effectiveness of thoracic manipulation (MAN) when compared to sham manipulation (SHAM) for individuals with LBP. BACKGROUND: Low back pain is one of the most prevalent and disabling musculoskeletal conditions. The management of LBP has been studied extensively, yet the most effective treatment strategies remain to be elucidated. METHODS: Patients with LBP were stratified based on symptom duration and randomly assigned to MAN or SHAM treatment groups. Groups received three visits which included core stabilization exercises and patient education. Factorial repeated measures ANOVA and multiple regression was performed for pain, disability, and fear-avoidance. Mann Whitney-U test was used to analyze patient perceived improvement with the Global Rating of Change scale (GROC) at follow up. RESULTS: Ninety participants completed the study (mean age 38 +/- 11.5 years; 70% female, 72% chronic LBP). The overall group-by-time interaction for the ANOVA was not significant for MODQ, NPRS, FABQ. GROC was not significantly different between the groups. CONCLUSION: Three sessions of thoracic manipulation, education, and exercise did not result in improved outcomes when compared to a sham manipulation, education, and exercise in individuals with chronic LBP. Future studies are needed to identify the most effective management strategies for the treatment of low back pain. Registered at ClinicalTrials.gov (NCT02853357). LEVEL OF EVIDENCE: Therapy, level 1b.

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