Neck pain study finds chiropractic and exercise more effective than medication
January 05, 2012
New research indicates that spinal manipulation and exercise are more effective at relieving neck pain in the long term than medications. The findings of a clinical study at Northwestern Health Sciences University in Bloomington, Minn., were published this month in The Annals of Internal Medicine.
Neck pain affects nearly 75 percent of the American population. Spinal manipulation by a chiropractor, physical therapy, and pain medicine are popular treatment options, but there was little scientific evidence supporting effective treatment. Many people seek relief from spinal manipulation by a chiropractor, but the evidence supporting its usefulness has not been conclusive. However the new research shows that chiropractic care simple exercises were better at reducing pain than taking medications.
“These changes were diminished over time, but they were still present. Even a year later, there were differences between the spinal manipulation and medication groups.” said Dr. Gert Bronfort, an author of the study and research professor at Northwestern Health Sciences University. Dr. Bronfort holds the Greenawalt Endowed Research Chair, funded through a restricted grant from Foot Levelers, Inc.
Moderate and acute neck pain is one of the most frequent reasons for trips to primary care doctors, prompting millions of visits every year. For patients, it can be a difficult problem to navigate. “There was a void in the scientific literature in terms of what the most helpful treatments are,” Dr. Bronfort said.
To find out, Dr. Bronfort and his colleagues recruited a large group of adults with neck pain that had no known specific cause. The subjects, 272 in all, were mostly recruited from a large HMO and through advertisements. The researchers then split them into three groups and followed them for about three months.
One group was assigned to visit a chiropractor for roughly 20-minute sessions throughout the course of the study, making an average of 15 visits. A second group was assigned to take common pain relievers like acetaminophen and — in some cases, at the discretion of a doctor — stronger drugs like narcotics and muscle relaxants. The third group met on two occasions with therapists who gave them instructions on simple, gentle exercises for the neck that they could do at home. They were encouraged to do 5 to 10 repetitions of each exercise up to eight times a day. (A demonstration of the exercises can be found at www.annals.org).
After 12 weeks, the people in the non-medication groups did significantly better than those taking the drugs. About 57 percent of those who met with chiropractors and 48 percent who did the exercises reported at least a 75 percent reduction in pain, compared to 33 percent of the people in the medication group. What was impressive is that the patients in the chiropractic and exercise groups maintained their improvement after one year.
Dr. Bronfort said it was a “big surprise” to see that the home exercises were about as effective as the chiropractic sessions. “We hadn’t expected that they would be that close,” he said. “But I guess that’s good news for patients.”
In addition to their limited pain relief, the medications had at least one other downside: people kept taking them. “The people in the medication group kept on using a higher amount of medication more frequently throughout the follow-up period, up to a year later,” Dr. Bronfort said. “If you’re taking medication over a long time, then we’re running into more systemic side effects like gastrointestinal problems.”
He also expressed concern that those on medications were not as empowered to care for themselves as the other groups. “We think it’s important that patients have the tools to care for their condition as much as possible,” Dr. Bronfort said. “This study shows that people can play a large role in their own care.”
About Northwestern Health Sciences University
Northwestern, based in Bloomington, provides world-class professional education and research, as well as comprehensive integrated health and wellness services, to people across the United States and around the world. The university's more than 130 faculty members annually teach approximately 6,500 students and professionals pursuing degrees in accredited programs and continuing education in chiropractic, acupuncture, therapeutic massage and other integrative health treatments. The university, which will celebrate its 75th anniversary in 2016, has more than 7,500 graduates throughout the U.S. and in 21 countries worldwide.
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