July 2005

Researchers report new findings
from UCLA neck-pain study

Researchers at UCLA have concluded, in a paper published in the July 1 issue of Spine, that chiropractic manipulation for neck pain is associated with a high rate of adverse reactions. They recommend mobilization instead of manipulation in cases of severe neck pain.

The study was done on the same population used in a paper presented at the 2002 annual meeting of the American Public Health Association.

The newer paper published in Spine is entitled “Frequency and Clinical Predictors of Adverse Reactions to Chiropractic Care in the UCLA Neck Pain Study.” The paper presented in 2002 was entitled “Outcomes from the UCLA Neck Pain Study.”

According to Eric L. Hurwitz, DC, PhD, the primary author of both papers, “The 2002 paper focuses on clinical (effectiveness) outcomes, whereas the 2005 paper focuses on adverse reactions.”

The study population consisted of 336 chiropractic patients suffering from neck from four southern California healthcare clinics. They were treated either by manipulation (with or without heat and with or without electrical muscle stimulation, EMS) or by mobilization (with or without heat and with or without EMS).

Of the 280 participants (83 percent) who responded to follow-up assessments, 85 (30.4 percent) reported adverse symptoms after treatment by chiropractic manipulation. The most common symptom reported was increased neck pain or stiffness. Headache and radiating pain were less commonly reported.

In the Spine report, Hurwitz and his associates conclude that adverse reactions appear more likely to follow cervical spine manipulation than mobilization.

The purpose of the 2002 study was “to estimate the effects of manipulation versus mobilization for neck pain and disability among neck-pain patients followed up for six months in a randomized clinical trial conducted among chiropractic patients.”

In the 2002 paper Hurwitz and his co-authors concluded, “The mean groups [manipulation and mobilization] were similar at each follow-up assessment. … After six months of follow-up, manipulation and mobilization for neck pain were comparable in their effectiveness.”

Hurwitz said, “The conclusions from each paper are entirely consistent. … We did not do an analysis of adverse reactions for the 2002 paper. The conclusion in the 2005 paper … is new and does not contradict any previous finding.”

As a sidenote, Medscape, a medical Web site from WebMD, reported on the study and offered it as a “News CME” (continuing education based on research news). It headlined its article, “Chiropractic Therapy for Neck Pain May Have High Rate of Adverse Reactions.”

The Medscape article begins, “Chiropractic therapy for neck pain has a high rate of adverse reactions, according to the results of a randomized study published in the July 1 issue of Spine. The investigators suggest that if chiropractic treatment is needed, mobilization is better than manipulation.”

Sources: Eric L. Hurwitz, DC, PhD, ehurwitz@ucla.edu; Spine. 30(13):1477-1484, July 1, 2005.; American Public Health Association, www.apha.org; Medscape, www.medscape.com

Industry News from:
Chiropractic News from: