When Can Chiropractic Care Help Neck Pain?Many people with neck pain seek help from chiropractors. Chiropractic care may vary depending on the underlying problem. Applying the right treatment for each patient is every chiropractor's goal.
In this study, chiropractors from The Netherlands try to find ways to tell which neck pain patients will respond to their care. They evaluated 29 possible factors that might predict treatment results. Each patient answered a series of questions before, during, and after treatment. They were followed for up to 12 months.
Some of these patient characteristics included age, general health, level of education, gender, and working status. Questions were also asked about other symptoms, medication used, prior episodes of neck pain, and workers' comp or sick-leave status. Fear or apprehension about treatment was also measured.
Over 500 patients participated in the study. As a group, the patients were mostly middle-aged women with a high school degree. They were employed, reported chronic neck pain that comes and goes, and were pretty healthy overall. Many reported other symptoms such as headaches, confusion, ringing in the ears, and fatigue or dizziness.
Not all the patients were treated in the same way. Each chiropractor involved in the study determined what type of treatment to give. The number of sessions was also left up to the chiropractor.
Other studies have shown which factors can predict a poor outcome (negative predictors). This study focused on positive prognostic factors. In other words, which clinical and/or social variables point to a good result with chiropractic care for neck pain?
The authors report the shorter duration of painful symptoms was the best predictor of overall beneficial effect of treatment. The sooner patients came in for treatment, the more likely they would receive benefit. On the other hand, the longer patients waited to receive treatment, the more likely it was that he or she would have a poor outcome.
They also found that patients who weren't on sick leave or workers' comp had better results. So did patients with a higher level of education and less fear or anxiety about the treatment. In fact, patients who expected to get better were more likely to improve with chiropractic care. Patients who didn't have pain in the morning were also more likely to have a favorable outcome.
This study showed that chiropractors can tell during the first patient appointment whether improvement or recovery is possible with chiropractic care. There are both positive and negative predictive factors that can be reviewed before planning the specific treatment.
Sidney M. Rubinstein, DC, MSc, et al. Predictors of a Favorable Outcome in Patients Treated by Chiropractors for Neck Pain. In Spine. June 1, 2008. Vol. 33. No. 13. Pp. 1451-1458.
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