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Daily Archives: March 11, 2012

Patient Satisfaction With Upper Cervical Chiropractic Care

By |March 11, 2012|Patient Satisfaction, Upper Cervical Adjusting|

Symptomatic Reactions, Clinical Outcomes and Patient Satisfaction Associated With Upper Cervical Chiropractic Care: A Prospective, Multicenter, Cohort Study

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SOURCE:   BMC Musculoskelet Disord. 2011 (Oct 5); 12: 219

Kirk Eriksen, Roderic P Rochester, and Eric L Hurwitz

Chiropractic Health Institute, PC,
2500 Flowers Chapel Road,
Dothan, AL 36305, USA.


BACKGROUND: Observational studies have previously shown that adverse events following manipulation to the neck and/or back are relatively common, although these reactions tend to be mild in intensity and self-limiting. However, no prospective study has examined the incidence of adverse reactions following spinal adjustments using upper cervical techniques, and the impact of this care on clinical outcomes.

METHODS: Consecutive new patients from the offices of 83 chiropractors were recruited for this practice-based study. Clinical outcome measures included:

1) Neck pain disability index (100-point scale),

2) Oswestry back pain index (100-point scale),

3) 11-point numerical rating scale (NRS) for neck, headache, midback, and low back pain,

4) treatment satisfaction, and

5) Symptomatic Reactions (SR).

Data were collected at baseline, and after approximately 2 weeks of care. A patient reaching sub-clinical status for pain and disability was defined as a follow-up score <3 NRS and <10%, respectively. A SR is defined as a new complaint not present at baseline or a worsening of the presenting complaint by >30% based on an 11-point numeric rating scale occurring <24 hours after any upper cervical procedure.

RESULTS: A total of 1,090 patients completed the study having 4,920 (4.5 per patient) office visits requiring 2,653 (2.4 per patient) upper cervical adjustments over 17 days. Three hundred thirty- eight (31.0%) patients had SRs meeting the accepted definition. Intense SR (NRS ≥8) occurred in 56 patients (5.1%). Outcome assessments were significantly improved for neck pain and disability, headache, mid-back pain, as well as lower back pain and disability (p <0.001) following care with a high level (mean = 9.1/10) of patient satisfaction. The 83 chiropractors administered >5 million career upper cervical adjustments without a reported incidence of serious adverse event.

CONCLUSIONS: Upper cervical chiropractic care may have a fairly common occurrence of mild intensity SRs short in duration (<24 hours), and rarely severe in intensity; however, outcome assessments were significantly improved with less than 3 weeks of care with a high level of patient satisfaction. Although our findings need to be confirmed in subsequent randomized studies for definitive risk-benefit assessment, the preliminary data shows that the benefits of upper cervical chiropractic care may outweigh the potential risks.


From the Full-Text Article:

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