It is unclear if among those with non-chronic back pain alternative treatments are useful. Chiropractic care or spinal manipulation therapy (SMT) appears similar to other recommended treatments. National guidelines reach different conclusions, with some not recommending spinal manipulation, some describing manipulation as optional, and others recommending a short course for those who do not improve with other treatments. A 2017 review recommended spinal manipulation based on low quality evidence. Manipulation under anaesthesia, or medically assisted manipulation, has not enough evidence to make any confident recommendation. Spinal manipulative does not have a significant benefits over motor control exercises.