Proven Means To Treat Neck Pain
In today’s podcast, we are going to talk about research on how to treat neck pain but hopefully in a fun way. We like to have fun on the Chiropractic Forward podcast. Let’s face it, research can be a bit boring so why not try to have some fun with it?
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Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast where we talk about issues related to health, chiropractic, evidence, and research and how those things all fit into a comprehensive approach for treating different conditions. Thank you for taking time out of your day to give us a listen. I know your time is valuable and I will always try hard to fill our time with valuable content.
In the words of Chris Berman, you have back back back backed into Episode #12 and this week we’re going to have more fun than having your teenage son spank you in video games that you’ve always beat him at. Yes, this recently happened to yours truly. Not only that but he did it with a pistol and I’m asham ed. Call of Duty was my safe space y’all…..
So, I’ll just bury myself into my work, stuff it deep down inside to explode at a later date.
Now, If you have spent any significant amount of time with our videos, podcasts, or blogs, you are probably aware that there is an excess of research regarding chiropractic’s effectiveness in patients suffering from low back pain.
Although there are some excellent research papers having to do with chiropractic and neck pain, I would argue that it demands more attention. Without question. The first reason being that neck pain is as important or more so than low back pain. In the paper we will be discussing this week, they cite research suggesting that neck pain is responsible for up to 25% of the patients seen in outpatient orthopedic practices and 50% of the general population will have neck pain at some point in their lives.
The second reason I believe neck pain demands more attention from our industry is that we have been unfairly labeled as the profession out there in the world causing strokes every day. There needs to be a clear, factual representation of the risk vs. reward ratio and, if there is a small body of evidence, our case doesn’t stand up quite as strongly.
To be more clear, there is an abundance of evidence that Chiropractic is not linked to strokes any more than going to the primary practitioner. However, there is scant evidence of Chiropractic’s effectiveness to treat neck pain WHEM COMPRAED to the research available to treat low back pain.
This does not mean there isn’t great research in our favor on hwo to treat neck pain. That is not what I’m saying at all. It just means we have not documented it through research in the amounts that we have for the low back pain and I would like to see more. If I were a researcher myself, it is the condition I would be targeting without question.
Now, with that being said, this week’s paper is titled “The Immediate Effects of Upper Thoracic Translatoric Spinal Manipulation on Cervical Pain and Range of Motion: A Randomized Clinical Trial” published in the Journal of Manual Manipulative Therapeutics in 2008 that shows the effectiveness of spinal manipulative therapy. Here’s the catch, it was performed by physical therapists, not chiropractors. It was done by John Krauss, PT, PhD, OCS, FAAOMPT, et. al. Look at all of those letters.
At this point, I would like to diverge from the original path for a few moments. If chiropractors are unaware, along with research validating the chiropractic adjustment to treat neck pain, low back pain, and other maladies comes more competition for the service. Physical therapists were restricted to muscles and exercise essentially. Now, they are adjusting. This is going to become a turf war between chiropractors doing what we have always done and physical therapists adopting our treatments as their own. Of course, physical therapists can’t call what they do “chiropractic adjustments” so they have changed the term to “translatoric spinal manipulation.” It’s irritating to the chiropractic profession but it is a fact the profession will be facing more and more in the years to come so be prepared for it. It is particularly irritating when you consider that physical therapists have been part of the medical machine that have torn down the chiropractic profession for generations prior to adopting its techniques as their own.
Now, back to the research paper.
Why They Did It
The authors of the paper wanted to determine the effectiveness of thoracic (upper back) adjustments to treat neck pain and neck range of motion.
How They Did It
- The active range of motion of the neck in each subject was measured before and after the manipulation. The term “active range of motion” means the patient turned their neck as far as possible in rotation both ways without the assistance of the researcher.
- The range of motion was measured with a cervical inclinometer.
- The patient’s neck pain was measured prior to and after treatment with the Faces Pain Scale. A quick trip to Wikipedia tells us that the Wong-Baker Faces Pain Rating Scale is a pain scale that was developed by Donna Wong and Connie Baker. The scale shows a series of faces ranging from a happy face at 0 which represents “no hurt” to a crying face at 10 which represents “hurts worst.”
- The study included 32 patients having pain in the cervical region and limited range of motion.
- 22 of these were randomly split into an experimental group while the other ten were randomly placed into a control group.
- The evaluator measuring the pre- and post-manipulation outcomes was a blinded evaluator to reduce risk of bias.
- The experimental (treatment) group received the manipulation treatment to the areas of the upper back region that had been determined to be hypomobile. In simpler terms, they delivered the adjustment to the areas of the upper back that were stiff or not moving like they should.
- The control group had no treatment.
- Paired t-tests were used to determine the changes within the group for cervical rotation and pain. A paired t-test is used to compare two population means where you have two samples in which observations in one sample can be paired with observations in the other sample.
- A 2-way repeated-measure ANOVA was used to analyze between-group differences in cervical rotation and pain. A two-way repeated measures ANOVA is often used in studies where you have measured a dependent variable over two or more time points, or when subjects have undergone two or more conditions. The primary purpose of a two-way repeated measures ANOVA is to understand if there is an interaction between these two factors on the dependent variable.
What They Found
- Significant changes were found for neck rotation within the group as well as between the groups.
- The translatoric spinal manipulative group showed more range of motion in right rotation as well as in left rotation.
- The levels of pain the subjects experienced after the manipulation were significantly reduced.
Wrap It Up
The authors of the paper concluded by saying, “This study supports the hypothesis that spinal manipulation applied to the upper thoracic spine (T1-T4 motion segments) significantly increases cervical rotation ROM and may reduce cervical pain at end range rotation for patients experiencing pain during bilateral cervical rotation.”
Did you know that research and clinical experience shows that, in about 80%-90% of headaches, neck, and back pain, compared to the traditional medical model, patients get good to excellent results with Chiropractic. It’s safe, more cost-effective, decreases chances of surgery, and reduces chances of becoming disabled. We do this conservatively and non-surgically with minimal time requirements and hassle on the part of the patient. And, if the patient develops a “preventative” mindset going forward, we can likely keep it that way while raising the general, overall level of health! What better way to treat neck pain?
Please feel free to send us an email at dr dot williams at chiropracticforward.com and let us know what you think or what suggestions you may have for us for future episodes. If you love what you hear, be sure to check out www.chiropracticforward.com. As this podcast builds, so will the website as we add more content, educational products, and a little further down the road, webinars, seminars, and speaking dates as they get added.
We cannot wait to connect again with you next week. From Creek Stone here in Amarillo, TX, home of the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.
Krauss J, et. al., “The Immediate Effects of Upper Thoracic Translatoric Spinal Manipulation on Cervical Pain and Range of Motion: A Randomized Clinical Trial.” J Man Manip Ther. 2008; 16(2): 93–99.