Visit Frequency and Outcomes for Patients Using Ongoing Chiropractic Care for Chronic Low-Back and Neck Pain: An Observational Longitudinal Study
A ChiroSecure Research Update
Abstract: Chronic spinal pain is prevalent and long-lasting. Although provider-based nonpharmacologic therapies such as chiropractic care have been recommended, healthcare and coverage policies provide little guidance or evidence regarding long-term use of this care.
Determine relationships between visit frequency and outcomes for patients using ongoing chiropractic care for chronic spinal pain.
Discussion: Data collected from patients of 124 chiropractic clinics in six US regions. 1,362 patients with chronic low-back pain (CLBP) and 1,214 with chronic neck pain (CNP) were included in a series of hierarchical linear modeling (HLM) models.
Unconditional (time-only) models showed patients on average had mild pain and function and significant, but slight improvements in these over the 3-month observation period: back and neck pain decreased by 0.40 and 0.44 points, respectively; function improved by 2.7 Oswestry Disability Index (ODI) and 3.0 points Neck Disability Index (NDI) (all p<.001).
Adding chiropractic visit frequency to the models revealed that those with worse baseline pain and function used more visits, but only visits more than once per week for those with CLBP were associated with significantly better improvement. These relationships remained when other types of visits and baseline patient characteristics were included.
Conclusion: This 3-month window on chiropractic patients with CLBP and/or CNP revealed that they were improving, although slowly; may have reached maximum therapeutic improvement; and are possibly successfully managing their chronic pain using a variety of chiropractic visit frequencies.
These results may inform payers when building coverage policies for ongoing chiropractic care for patients with chronic pain.
Reference: Herman PM, Edgington SE, Sorbero ME, Hurwitz EL, Goertz CM, Coulter ID. Visit Frequency and Outcomes for Patients Using Ongoing Chiropractic Care for Chronic Low-Back and Neck Pain: An Observational Longitudinal Study. Pain Physician. 2021 Jan;24(1):E61-E74. PMID: 33400439; PMCID: PMC8667562. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8667562/