Minneapolis Chiropractor Best Practices;
Research Commentary

Chiropractic Care for Neck Pain

A review of

Muhammad Sharif Waqas, Hossein Karimi, Ashfaq Ahmad, Shazia Rafiq, Naveed Anwar, Sidrah Liaqat, “The Effects of Spinal Manipulation Added to Exercise on Pain and Quality of Life in Patients with Thoracic Spinal Pain: A Randomized Controlled Trial”, BioMed Research International, vol. 2023, Article ID 7537335, 7 pages, 2023. https://doi.org/10.1155/2023/7537335

Reviewed by Dr. Justin Thompson

Chiropractic Care for Neck Pain

A Summarized Review of the Conclusion

Spinal manipulation which is utilized in chiropractic care, utilized in addition to thoracic exercise was more effective than thoracic exercise alone for improving thoracic pain and quality of life. This is significant because it adds to the collection of research showing the effectiveness of the high velocity, low amplitude adjustment that we utilize in our clinics. Additionally, it shows that now only does spinal manipulation decrease pain, it is beneficial to overall quality of life.

Quotes from the Article

“This is the first trial evaluating the effect of adding spinal manipulation to thoracic exercise for the treatment of thoracic back pain. The purpose of this study was to gather evidence for the effects of thoracic spinal manipulation on pain and health-related quality of life in subjects with thoracic spinal pain.”

“The results of the present study show that there is a significant difference between groups in the reduction of pain.”

“Both physical and mental components of SF 36 showed improvement within both groups, but between-group comparison has shown that spinal manipulation was more effective in improving health-related quality of life immediately after treatment and effects were lost after the discontinuation of manipulation treatment but persists in exercise group which is persistent with previous literature”

“In treating a patient, holistic- and patient-centered approach is required and acknowledging the fact that psychological, environmental, nutritional, and emotional factors may have an impact on physical and social aspects of individuals”

Introduction to The Research

Spinal pain is considered the leading cause of disability in individuals worldwide. But thoracic spinal pain, which might be but not exclusively related to other spinal pathologies, is an underexplored region. Epidemiological data on thoracic pain in the general population is also limited as compared to other spinal regions. It is suggested that manual therapy shows improvement in symptoms by exerting biomechanical and neurophysiological effects. The neurophysiological effect can stimulate the sympathetic nervous system, this in turn can increase skin conductance, respiratory rate and heart rate, suggesting sympathetic excitatory effect. It also produces hypoalgesia by affecting pain processing centers, endocrine responses, and increasing pressure pain threshold. In the medical community, pain is considered a challenging problem. As it is a complex pathophysiological process, it can have an impact on the social and psychological well-being of a person. It was hypothesized that spinal manipulation with thoracic spinal exercises is more effective than thoracic spinal exercise alone on pain and quality of life in patients with thoracic spinal pain.

Research Methodology

A parallel group randomized controlled trial was conducted. Random allocation into two groups was made by a computer generated randomization table. For this study, a total of 127 subjects were assessed, out of which 100 participants including both male and female, ages between 16 and 60 years, who were having nonspecific thoracic spine pain, like neck pain, in the spinal area T1 to T12, mobility deficit in thoracic spinal range of motion, and having pain with compression on the thoracic spine, were included in the study. In the experimental group (n=50), thoracic spinal manipulation was applied along with thoracic muscle strengthening exercises. In the control group (n=50) thoracic muscle exercises alone were given. Pain was measured by visual analogue scale (VAS) and quality of life with SF-36. Measurements were taken at baseline, immediately after session, after 8th session, and later as follow-ups at 12 weeks. Repeated measures ANOVA and independent sample -test were used for within and between-group comparisons.

Research Findings

Both groups demonstrated significant improvement in VAS score, and all domains of SF 36 but between-group comparison showed greater improvement in VAS of the experimental group compared to the baseline (P<0.05), but between-group comparison of 8th session to follow-up has shown that effects of exercise persist while health-related quality of life in spinal manipulation group was significantly reduced after discontinuation of treatment. After the 8th session, the spinal manipulation group showed notable results in terms of pain (mean diff 1.14 (0.62, 1.65) 95% CI and all aspects of SF 36 (value <0.05).


Research References

As always with these reviews, these are my takeaways from the article and I encourage you to read the article in its entirety.  The references used in this article by the authors of this article are listed here.


Our Message

We love to help our patients in St. Louis Park stay healthy. We are here to relieve back pain, neck pain and headaches while also teaching about how our diet and stress effects our over all health. By improving these areas of our lives we can become healthier, stay out of pain and reduce risk of diseases. Our Chiropractors located in the West End, near the corner of MN-100 S & Lake Rd./Westside Dr., want to help you stay healthy and out of pain with Chiropractic Care for Neck Pain!