What is the recommended age for Spinal Manipulative and Thrust (SMART) therapy?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: February 15, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Research

Recommended Age for Spinal Manipulative and Thrust (SMART) Therapy

There is no specific age recommendation for Spinal Manipulative and Thrust (SMART) therapy, as the provided studies do not directly address this question. However, the studies do provide information on the effectiveness of spinal manipulative therapy (SMT) and thrust manipulation (TM) in different age groups:

  • A study published in 2022 1 found that SMT is effective in older adults (65-91 years) with chronic low back pain, with moderate-quality evidence showing similar outcomes to recommended interventions for pain and functional status.
  • A study published in 2013 2 compared the effects of thrust manipulation (TM) and non-thrust manipulation (NTM) on older adults (55-88 years) with low back pain, and found that both TM and NTM improved outcomes, with no significant between-group differences.
  • A study published in 2025 3 found that the effectiveness of SMT does not depend on the application procedures, and that clinicians can apply SMT according to their preferences and the patients' preferences and comfort.
  • A study published in 2024 4 found that adding thrust spinal manipulation and electrical dry needling to conventional physical therapy improved outcomes in patients with lumbar spinal stenosis, but did not specify an age range.
  • A case series published in 2016 5 described the use of lumbar thrust manipulation and exercise in adolescents (13-15 years) with mechanical low back pain, and found that it was a safe and effective adjunct therapy.

Age-Related Considerations

The studies suggest that SMT and TM can be effective in different age groups, including:

  • Older adults (65-91 years) 1, 2
  • Adults with spine pain 3
  • Patients with lumbar spinal stenosis (no specific age range specified) 4
  • Adolescents (13-15 years) 5 However, it is essential to note that the effectiveness and safety of SMART therapy may depend on individual factors, such as the presence of underlying medical conditions, and should be determined on a case-by-case basis.

References

Research

Spinal manipulative therapy in older adults with chronic low back pain: an individual participant data meta-analysis.

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.