August 2007

Conventioneers preview major neck-pain study

A seven-year project by the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders will reveal major findings when it is published at the end of this year in both Spine and the European Spine Journal. The study was previewed Aug. 18 at the plenary session at the Florida Chiropractic Association’s national conference.

According to Scott Haldeman, DC, MD, PhD, one of the researchers on the task force, “The study will tell you what is known and why you need to know it. … The problem for clinicians is inconsistent information on the most effective approach to help patients with neck pain. We have a lack of understanding of diagnostic tests that are valid and a lack of understanding on how to justify treatment.” The study will provide information to help clinicians deal with these problems, he said.

Haldeman explained that patients universally come to chiropractors because of neck and back pain. “Even wellness clinics get 17 percent of their patients because of neck pain and headaches,” he told the audience. “Neck pain and headaches make up a major proportion of chiropractic practice and there is a need for chiropractors and other clinicians to understand what is known about this condition and provide the most up-to-date knowledge to their patients.”

The task force is comprised of a 13-member secretariat, a 17-member advisory council, and a large number of research associates. It was supported by eight universities in North America and Europe.

Haldeman said the task force had diffused financial support from insurance, government, industry, foundation, and professional societies. Malpractice insurers NCMIC and CCPA, the original supporters, seeded the study with a grant of $2 million.

The task force conducted a systematic review of literature, using tight screening procedures, said Haldeman. It also conducted five original research projects. The target audiences for the task force’s findings are clinicians, the legal system, insurers, the general public, and people with neck pain.

Most of the plenary session was devoted to previews of the results of the task force’s study. The audience heard 15-minute synopses on:

• “How serious is the problem of neck pain following motor vehicle crashes, in occupational settings, and in the general public?”
• “What treatments for neck pain can be justified based on the available evidence?”
• “What is the impact of the risks and benefits of neck pain treatments on patients’ health? Results of a decision analysis comparing common neck pain treatments.”
• “How does the scientific evidence advise us on the examination of patients and the documentation of patient response to treatment?”
• “What is the natural history of neck pain and what affects the future course of neck pain? How do we advise patients?”
• “Is the risk of stroke following chiropractic visits greater than the risk of stroke following primary care physician visits? Results of the Canadian Stroke study.”

In addition to Haldeman, presenters included Linda Carroll, PhD, and Eric Hurwitz, DC, PhD.

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