The treatment of migraine patients within chiropractic: analysis of a nationally representative survey of 1869 chiropractors

doi:10.1186/s12906-017-2026-3

Table 3

Distribution of clinical management characteristics across frequency of practitioner treating patients with migraine

Characteristic Treat patients with migraine p-value
Never/rarely/
sometimes
(n = 879) Often
(n = 990)
Care plan includes (discussed often)
Diet/nutrition 379 (43.2) 565 (57.4) < 0.001
Smoking/drugs/alcohol 171 (19.5) 295 (30.1) < 0.001
Physical activity/fitness 724 (82.8) 861 (87.5) 0.005
Occupational health and safety 325 (37.4) 439 (44.8) 0.001
Pain counselling 175 (20.2) 285 (29.3) < 0.001
Nutritional supplements 261 (29.8) 435 (44.1) < 0.001
Medications (including pain/inflammation) 165 (19.1) 264 (27.0) < 0.001
Conditions (treated often)
Neck pain: Axial 780 (88.8) 967 (97.8) < 0.001
Neck pain: Referred/radicular 374 (42.5) 799 (80.7) < 0.001
Thoracic pain: Axial 654 (74.8) 922 (93.4) < 0.001
Thoracic pain: Referred/radicular 227 (26.1) 632 (64.4) < 0.001
Low back pain: Axial 793 (90.5) 968 (98.2) < 0.001
Low back pain: Referred/radicular 600 (68.5) 910 (92.2) < 0.001
Lower limb musculoskeletal disorders 395 (45.0) 729 (73.8) < 0.001
Upper limb musculoskeletal disorders 416 (47.4) 748 (76.1) < 0.001
Postural disorders 442 (50.5) 765 (77.7) < 0.001
Degenerative spine conditions 642 (73.1) 986 (99.7) < 0.001
Headaches (tension, cervicogenic) 642 (73.0) 986 (100.0) < 0.001
Migraine disorders
Spine health maintenance/prevention 529 (60.3) 834 (84.8) < 0.001
Non-Musculoskeletal conditions 106 (16.8) 306 (41.2) < 0.001
Patient groups (treated often)
Child: <4 years 198 (22.7) 362 (36.8) < 0.001
4–18 years 363 (41.6) 627 (63.6) < 0.001
Older: >65 years 574 (65.8) 794 (80.6) < 0.001
Aboriginal and Torres Strait islander 8 (0.9) 24 (2.5) 0.012
Pregnant women 233 (26.8) 448 (45.7) < 0.001
Athletes/sports people 339 (39.1) 572 (58.5) < 0.001
Work Injuries 250 (38.9) 418 (42.8) < 0.001
Traffic Injuries 58 (6.7) 196 (20.1) < 0.001
Post-Surgical Rehabilitation 32 (3.7) 88 (9.0) < 0.001
Non-English Speaking ethnic groups 43 (5.1) 72 (7.5) 0.035
Techniques/methods (used often)
Drop-piece 443 (51.0) 549 (56.7) 0.015
Pelvic blocking/sacro-occipital 343 (39.7) 465 (48.1) < 0.001
Instrument Adjusting 420 (48.4) 545 (56.0) 0.001
Chiropractic Biophysics 28 (3.3) 49 (5.4) 0.040
HVLA manipulation/mobilisation 694 (80.0) 821 (84.1) 0.023
Applied kinesiology 113 (13.1) 182 (19.1) 0.001
Flexion-Distraction 65 (7.6) 81 (8.5) 0.472
Functional Neurology 71 (8.4) 168 (17.8) < 0.001
Extremity Manipulation 443 (50.9) 648 (66.5) < 0.001
Musculoskeletal Interventions (used often)
Dry Needle or acupuncture 98 (11.3) 153 (15.7) 0.006
Soft tissue therapies 573 65.9 650 (66.1) 0.905
Electro-modalities 71 (8.6) 103 (10.6) 0.147
Heat/cryotherapy 118 (13.7) 184 (18.9) 0.002
Orthotics 55 (6.4) 134 (13.8) < 0.001
Exercise therapy/rehabilitation 411 (47.7) 497 (51.1) 0.140

Characteristic	Treat patients with migraine		p-value
Characteristic	Never/rarely/ sometimes (n = 879)	Often (n = 990)	p-value
Care plan includes (discussed often)
Diet/nutrition	379 (43.2)	565 (57.4)	< 0.001
Smoking/drugs/alcohol	171 (19.5)	295 (30.1)	< 0.001
Physical activity/fitness	724 (82.8)	861 (87.5)	0.005
Occupational health and safety	325 (37.4)	439 (44.8)	0.001
Pain counselling	175 (20.2)	285 (29.3)	< 0.001
Nutritional supplements	261 (29.8)	435 (44.1)	< 0.001
Medications (including pain/inflammation)	165 (19.1)	264 (27.0)	< 0.001
Conditions (treated often)
Neck pain: Axial	780 (88.8)	967 (97.8)	< 0.001
Neck pain: Referred/radicular	374 (42.5)	799 (80.7)	< 0.001
Thoracic pain: Axial	654 (74.8)	922 (93.4)	< 0.001
Thoracic pain: Referred/radicular	227 (26.1)	632 (64.4)	< 0.001
Low back pain: Axial	793 (90.5)	968 (98.2)	< 0.001
Low back pain: Referred/radicular	600 (68.5)	910 (92.2)	< 0.001
Lower limb musculoskeletal disorders	395 (45.0)	729 (73.8)	< 0.001
Upper limb musculoskeletal disorders	416 (47.4)	748 (76.1)	< 0.001
Postural disorders	442 (50.5)	765 (77.7)	< 0.001
Degenerative spine conditions	642 (73.1)	986 (99.7)	< 0.001
Headaches (tension, cervicogenic)	642 (73.0)	986 (100.0)	< 0.001
Migraine disorders
Spine health maintenance/prevention	529 (60.3)	834 (84.8)	< 0.001
Non-Musculoskeletal conditions	106 (16.8)	306 (41.2)	< 0.001
Patient groups (treated often)
Child: <4 years	198 (22.7)	362 (36.8)	< 0.001
4–18 years	363 (41.6)	627 (63.6)	< 0.001
Older: >65 years	574 (65.8)	794 (80.6)	< 0.001
Aboriginal and Torres Strait islander	8 (0.9)	24 (2.5)	0.012
Pregnant women	233 (26.8)	448 (45.7)	< 0.001
Athletes/sports people	339 (39.1)	572 (58.5)	< 0.001
Work Injuries	250 (38.9)	418 (42.8)	< 0.001
Traffic Injuries	58 (6.7)	196 (20.1)	< 0.001
Post-Surgical Rehabilitation	32 (3.7)	88 (9.0)	< 0.001
Non-English Speaking ethnic groups	43 (5.1)	72 (7.5)	0.035
Techniques/methods (used often)
Drop-piece	443 (51.0)	549 (56.7)	0.015
Pelvic blocking/sacro-occipital	343 (39.7)	465 (48.1)	< 0.001
Instrument Adjusting	420 (48.4)	545 (56.0)	0.001
Chiropractic Biophysics	28 (3.3)	49 (5.4)	0.040
HVLA manipulation/mobilisation	694 (80.0)	821 (84.1)	0.023
Applied kinesiology	113 (13.1)	182 (19.1)	0.001
Flexion-Distraction	65 (7.6)	81 (8.5)	0.472
Functional Neurology	71 (8.4)	168 (17.8)	< 0.001
Extremity Manipulation	443 (50.9)	648 (66.5)	< 0.001
Musculoskeletal Interventions (used often)
Dry Needle or acupuncture	98 (11.3)	153 (15.7)	0.006
Soft tissue therapies	573 65.9	650 (66.1)	0.905
Electro-modalities	71 (8.6)	103 (10.6)	0.147
Heat/cryotherapy	118 (13.7)	184 (18.9)	0.002
Orthotics	55 (6.4)	134 (13.8)	< 0.001
Exercise therapy/rehabilitation	411 (47.7)	497 (51.1)	0.140