Prediction of Outcomes with Chiropractic Care and Cervical Pain
A report on the scientific literature
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP
Pain located in the neck is a very common condition. Neck pain can come from a number of activities, disorders and diseases in the neck, such as degenerative disc disease, neck strain, whiplash, a herniated disc, or a pinched nerve. It can also come from overuse, sports injuries, and everyday home and work related activities. Usually, there is an underlying instability or problem in the neck that is a precursor to the pain. Neck pain is also referred to as cervical pain.
"Neck pain is commonly associated with dull aching. Sometimes pain in the neck is worsened with movement of the neck. Other symptoms associated with some forms of neck pain include numbness, tingling, tenderness, sharp shooting pain, fullness, difficulty swallowing, pulsations, swishing sounds in the head, dizziness or lightheadedness, and gland swelling" (MedicineNet.com, 2008, http://www.medicinenet. com/neck_pain/article.htm).
"There are seven vertebrae that are the bony building blocks of the spine in the neck (the cervical vertebrae) that surround the spinal cord and canal. Between these vertebrae are discs, and nearby pass the nerves of the neck" (MedicineNet.com, 2008, http://www.medicinenet.com/neck_pain/article.htm).
"Incredibly, the cervical spine supports the full weight of your head, which is on average about 12 pounds. While the cervical spine can move your head in nearly every direction, this flexibility makes the neck very susceptible to pain and injury" (American Chiropractic Association, n.d., http://www.acatoday.or/ content_css.cfm?CID=2430).
"The neck’s susceptibility to injury is due in part to biomechanics. Activities and events that affect cervical biomechanics include extended sitting, repetitive movement, accidents, falls and blows to the body or head, normal aging, and everyday wear and tear" (American Chiropractic Association, n.d., http://www.acatoday. or/content_css.cfm?CID=2430).
Further detailed explanations of some of the causes of neck pain are:
"Injury and Accidents: A sudden forced movement of the head or neck in any direction and the resulting "rebound" in the opposite direction is known as whiplash. The sudden "whipping" motion injures the surrounding and supporting tissues of the neck and head. Muscles react by tightening and contracting, creating muscle fatigue, which can result in pain and stiffness. Severe whiplash can also be associated with injury to the intervertebral joints, discs, ligaments, muscles, and nerve roots. Car accidents are the most common cause of whiplash" (American Chiropractic Association, n.d., http://www.acatoday.or/ content_css.cfm?CID=2430).
"Growing Older: Degenerative disorders such as osteoarthritis, spinal stenosis, and degenerative disc disease directly affect the spine.
- Osteoarthritis, a common joint disorder, causes progressive deterioration of cartilage. The body reacts by forming bone spurs that affect joint motion.
- Spinal stenosis causes the small nerve passageways in the vertebrae to narrow, compressing and trapping nerve roots. Stenosis may cause neck, shoulder, and arm pain, as well as numbness, when these nerves are unable to function normally.
- Degenerative disc disease can cause reduction in the elasticity and height of intervertebral discs. Herniated discs are NOT an effect of growing older and are a direct effect of trauma, but can also cause similar reduction in elasticity and height of the intervertebral disc, but have the potential to cause more serious problems.
"Daily Life: Poor posture, obesity, and weak abdominal muscles often disrupt spinal balance, causing the neck to bend forward to compensate. Stress and emotional tension can cause muscles to tighten and contract, resulting in pain and stiffness. Postural stress can contribute to chronic neck pain with symptoms extending into the upper back and the arms" (American Chiropractic Association, n.d., http://www.acatoday. or/content_css.cfm?CID=2430).
When considering solutions for neck pain, you must look at what will help you and how long it will take to get better. Like with any malady, the progression of treatment should be drugless first, involve drugs second and have surgery as a final option. A significant factor must be the scientific evidence that predicts the outcome of any treatment. A cancer patient or a heart disease patient, prior to undergoing chemotherapy or open heart surgery, will ask the doctor what the percentage of success is for the treatment. The same question should be asked of every doctor for every treatment and chiropractic is no different.
In 2008, Thiel and Bolton studied 19,722 patients that were treated for a variety of symptoms, most of which were pain or stiffness in the neck, shoulder or arm region. The purpose of the study was to determine the outcome of chiropractic care in patients with nonspecific musculoskeletal disorders, including mechanical neck disorders. The results revealed that 71.6% of females and 67.9 % of males had immediate improvement. This shouldn’t be confused with the overall satisfaction rate of 94% of patients treated with acute neck pain as reported by Haneline (2006), asThiel and Bolton (2008) examined immediate improvement, not improvement over time as Haneline did.
Since statistics can be manipulated in many different ways, let’s examine those patients who experienced immediate worsening. The Thiel and Bolton (2008) study revealed that 95.2% of females and 96.2% of males reported no immediate worsening, rendering an overwhelming predictor of a successful outcome. Predictable outcomes are critical in guiding both the public and the doctor in realizing a successful treatment plan.
These studies, along with many others, conclude that a drug-free approach of chiropractic care is one of the best solutions to treat neck pain. To find a qualified doctor of chiropractic near you, go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.
1. MedicineNet.com. (2008, January). Neck pain. Retrieved from http://www.medicinenet.com/neck_pain/article.htm
2. American Chiropractic Association. (n.d.). Chiropractic and neck pain: Conservative care of cervical pain, injury. Retrieved from http://www.acatoday.org/content_css.cfm?CID=2430
3. Thiel, H. W., & Bolton, J. E. (2008). Predictors for immediate and global responses to chiropractic manipulation of the cervical spine. Journal of Manipulative and Physicological Therapeutics, 31(3), 172-183.