Mechano responsiveness of neuroimmune cross-talk in bone and joints: A narrative review with implications for force-based manipulations.

This is a narrative review. No search strategy or inclusion criteria are reported, so which studies were chosen and how much weight each gets is the authors' judgment, and no results were pooled numerically. Most human studies were small, used different techniques and treatment doses, and often had no sham control group, which the authors state themselves. Almost none of the human studies measured bone itself, so a change in a blood, saliva or urine chemical cannot be read as a change in bone quality. Some interventions were delivered as packages, for example multimodal chiropractic care that mainly includes spinal manipulation, so no single component can be credited with the change. The clearest bone results come from animal work in rats, mice and rabbits, and the authors note that many more human studies are needed before efficacy or effectiveness can be claimed.

The authors declare no conflicts of interest and no competing interests. The article text supplied does not name a funder.

Do not read this review as evidence that massage, acupuncture or spinal manipulation build bone. Almost none of the human studies measured bone; they measured chemicals in blood, saliva or urine, the results were inconsistent across studies, and the authors themselves say those treatments cannot yet be claimed to work.