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Title The use of chiropractic therapy in the treatment of cervical pain
Clinical Question In an otherwise healthy adult patient, is chiropractic therapy, compared to more conventional therapies, effective in reducing cervical pain?
Clinical Bottom Line Chiropractic therapy may be an effective treatment of cervical pain but there is a lack of rigorous trial data to support the superiority of chiropractic treatment over other therapies. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 9213278 Shekelle/19979 controlled trials of cervical spine manipulationSystematic Review
Key resultsAlthough the data on cervical spine manipulation is somewhat limited, based on the available data and a multidisciplinary expert panel, the authors concluded that cervical spine manipulation may be an appropriate therapy for some patients with neck pain.
#2) 10458312 Kjellman/199927 randomized controlled clinical trials published 1966-1995Systematic Review
Key resultsThe authors of this study considered 27 studies in their analysis. The authors reported that most of the studies were not of high methodological quality and had insufficient follow-up periods. A few studies showed "a slight tendency towards positive results, but the number of publications considered was inadequate to allow general conclusions to be drawn" (p. 151). Further research is required to determine whether these positive effects are actually present.
Evidence Search ("Chiropractic"[Mesh] AND "Neck Pain"[Mesh]) AND (Therapy/Broad[filter])
Comments on
The Evidence
Both studies are systematic reviews, representing a high level of evidence. However, the studies included in these systematic reviews were reported by the authors to not be of the highest methodological quality. Additionally, these studies were completed over 10 years ago so the evidence is dated.
Applicability The conclusions of these articles are applicable for all patients, in otherwise good health, who experience mild to moderate mechanical cervical pain.
Specialty/Discipline (General Dentistry)
Keywords Cervical pain, chiropractic therapy, chiropractic spinal manipulation, neck pain, exercise treatment
ID# 496
Date of submission: 01/26/2010spacer
Author Tom Laster
Co-author(s) Elizabeth Wallmann
Co-author(s) e-mail elizabeth.wallmann@gmail.com
Faculty mentor/Co-author Edward F. Wright, DDS, MS
Faculty mentor/Co-author e-mail WrightE2@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
Comments and Evidence-Based Updates on the CAT
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by Tess Simmons (San Antonio, Texas) on 04/09/2012
I conducted a PubMed search on this topic April 9, 2012 and found a more recent systematic review publication (PubMed: 14622659 ) that maintains chiropractic therapy is an effectively equivalent treatment but not superior to conventional exercise treatment. Additional randomized controlled clinical trials conducted since your original search date also support lack of evidence that one treatment is superior to the other (20350669 and 20801246).

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