Physical medicine and complementary approaches.

Medical approaches to the treatment of spine pain are the cornerstone of therapy for neck and back pain. Although these techniques are used widely, seldom have they been subjected to the scrutiny of careful randomized and controlled clinical trials. The costs of complementary treatments, such as spinal manipulation, massage therapy, and acupuncture, now are reimbursed by many medical insurance providers, but these modalities lack much scientific support. Physical medicine and complementary treatment modalities and some of the scientific studies aimed at assessing their effectiveness are reviewed.