Chiropractors that specialize in the treatment of
neck pain attempt to improve the
function of the joints and the nervous system by adjusting
Manual spinal adjustments are the key to chiropractic
treatment, and, in fact, the
word "chiropractic" is derived from the
two Greek words "cheiros" and "praktikos,"
which together mean, "done by hand." Chiropractic
adjustments are very popular in
the United States, with as many as 40 million Americans
receiving regular treatments.
Source: Neck Reference.com - May 01, 2002
Neck pain is a common neuromusculoskeletal disorder
in the United States, with an estimated prevalence
rate of 13 to 18 % within the general population.
Doctors of chiropractic commonly treat patients with
neck pain. In fact, a study involving
7,527 patients revealed that 12.7% presented to DCs
complaining of neck pain
and a study by Wolsko, et al. found that chiropractic
was used by 20% of 644
patients with back or neck pain.
Source: Michael Haneline, DC - American Chiropractic
Association - October 2004
183 adults were randomly selected to receive manual
therapy, physiotherapy (PT)
or care from a general practitioner (GP) for six weeks.
All of the patients suffered
neck pain for a minimum of two weeks; 66 percent had
received some form of
treatment for the condition prior to enrolling in
Manual therapy consisted of a variety of interventions,
techniques such as low-velocity spinal mobilization,
a technique the authors noted
is utilized frequently by doctors of chiropractic.
Spinal manipulation was not provided, however. Treatment
sessions lasted 45 minutes once per week, for a maximum
of six sessions.
Physiotherapy consisted of postural relaxation exercises,
stretching and functional
exercises, but the mobilization techniques offered
in the manual therapy group were discouraged from
use. PT treatments were offered twice a week (30 minutes
session) for a maximum of 12 sessions.
Source: Dynamic Chiropractic, 2003.
Risk Factors for Neck Pain
More and more people are now making their living
sitting at a desk. The use of
computers have risen astronomically and many of us
spend eight to ten hours a day
slumped over the keyboard and staring at the monitor.
When we sit with our head in
a forward bent position, the posture that most desk
workers assume, the ligaments
that hold the facets together and the muscles in the
neck are put under tremendous
strain. In addition the normal forward curve of the
neck becomes reversed causing
more stress upon all the surrounding tissues of the
neck. All of this can lead to spinal problems including
disc herniation and subluxations, which are the main
spinal nerve irritation. Besides pain, spinal nerve
irritation in the neck can cause
symptoms including headaches, eye problems, giddiness,
arm and hand pain and paraesthesia, as well as shoulder
Source: Chiropractic Care Pte Ltd
GP care consisted mainly of a "wait and see"
approach that included advice
offered by a general practitioner, along with an educational
booklet. Drugs were
prescribed if necessary, but patients were encouraged
to await "spontaneous
recovery." Patients had the option of 10-minute
follow-up visits with the doctor
every two weeks.
Outcomes of care were measured at the start of the
study and at 3-, 7-, 13-
and 52-week intervals. At 26 weeks' follow-up, patients
received a mail-in
questionnaire. Among the outcomes measured, patients
rated their perceived
recovery from neck pain; intensity of pain, functional
disability and utility with
Manual therapy was considered "the most effective
treatment" in the study. After
seven weeks, recovery rates in the manual-therapy
group were 68 percent,
compared to 51 percent and 36 percent in the PT and
GP groups, respectively.
Differences in recovery rates remained statistically
significant at the 26-week mark,
and were still superior for manual therapy at 52 weeks.
The association of psychosocial factors and chronic
neck pain is well established.
The UCLA Neck Pain Study offers an opportunity to
address these concerns.
Three-hundred-thirty-six neck pain patients presenting
to a large managed-care
facility between February, 1998 and June, 2000 were
randomized to 8 treatment
groups in a balanced 2x2x2 factorial design: spinal
manipulation with and without
heat therapy and with and without electrical muscle
stimulation; and spinal
mobilization with and without heat therapy and with
and with out electrical muscle
Two-hundred-sixty-nine patients (80%) were followed
over six months.
Primary outcome measures are average and most severe
neck pain intensity over
the past week, and neck-pain related disability. Psychosocial
occupational stressors, locus of control, sense of
personal responsibility for one's
health, perceived social support, and seeing oneself
as sickly) varied considerably
among the study participants, but were not related
to clinical outcomes. The results
were consistent across all treatment groups. Chiropractic
care appears to be
equally effective for patients regardless of their
Source: Michael S. Goldstein, PhD1, Hal Morgenstern,
PhD2, Eric Hurwitz, DC, PhD3,
and Fei Yu, PhD3. (1) Department of Community Health
Sciences, Universtiy of
California, Los Angeles, School of Public Health,
10833 Le Conte Ave., Los
Angeles, CA 90095, 310-825-5116, firstname.lastname@example.org,
(2) Department of
Epidemiology, University of California, Los Angeles,
School of Public Health,
10833 Le Conte Ave., Los Angeles, CA 90095, (3) Department
UCLA, School of Public Health, 10833 Le Conte Ave.,
Los Angeles, CA 90095
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