Check this recent link initially..
A systematic review of systematic reviews of spinal manipulation -- Ernst and Canter 99 (4): 192 -- Journal of the Royal Society of Medicine
Link shows "sys reviews of sys reviews for spinal manips" - "SM is not effective in any medical condition"
---Insight is to check whether SM works in specific pathologies like disc herniation--

Now check this link..
http://www.sciencedirect.com/science...24ba2735065f07
Link shows
"lack of strong evidence to support the role of spinal manipulation in disc herniation" &
"Need for quality research" &
"underlying pathophysiological mechanisms of benefit or harm are poorly understood"
---Now we need to luk out for a balanced research evidence which is not biased to confirm whether SM is effective or not---


Now check this link...
JRSM -- Sign In Page
Link shows "balanced sys review" - "no biomedical approach like SM in isolation is adequate for common musculoskeletal conditions" - "Packaged care is required"
---Now what's packaged care? Its nothing but a target specific combination therapy which is well thought and planned treatment for the underlying pathology--

Now check this link to find out one such SM treatment...
http://www.sciencedirect.com/science...62282e70aa930b
Recently proposed Interdisciplinary packaged care - "Manipulation under joint anesthesia/analgesia: A proposed interdisciplinary treatment approach for recalcitrant spinal axis pain of synovial joint origin"
---We have to be more target specific while planning out tx, considering novel medical approaches---