Neck Pain

The Prevalence and Progression of Neck and Back Pain in Children Over Time

By Frank M. Painter|July 3, 2013|Chiropractic Care, Neck Pain, Pediatrics|

The Prevalence and Progression of Neck and Back Pain in Children Over Time

SOURCE: Musculoskelet Disord. 2011 (May 16); 12: 98

Per Kjaer, Niels Wedderkopp, Lars Korsholm,
and Charlotte Leboeuf-Yde

Institute of Sports Science and Clinical Biomechanics,
Part of Clinical Locomotion Network,
University of Southern Denmark,
Campusvej 55, DK-5230, Odense, Denmark

The following article appears to be the first study to track and review the progression of back pain in the same group of children, over a prolonged period, to see how (or if) it is a contributor to those same complains in adulthood.

Of particular interest is Table 2, because it breaks down and tracks complaints of either neck, mid back, or low back pain in the same group of children at 3 different time periods: ages 9, 13 and 15 years old.

Table 2: Prevalence rates of different types of back pain in a cohort of Danish children/adolescents surveyed at three time points

Age Group	Age 9	Age 13	Age 15
Neck Pain
All children Boys Girls	10%9%11%	7%5%9%	15%13%18%
Mid Back Pain
All children Boys Girls	20%22%19%	13%13%13%	28%22%32%
Low Back Pain
All children Boys Girls	33%32%34%	28%26%30%	48%39%54%

The Abstract:

BACKGROUND: It is generally acknowledged that back pain (BP) is a common condition already in childhood. However, the development until early adulthood is not well understood and, in particular, not the individual tracking pattern. The objectives of this paper are to show the prevalence estimates of BP, low back pain (LBP), mid back pain (MBP), neck pain (NP), and care-seeking because of BP at three different ages (9, 13 and 15 years) and how the BP reporting tracks over these age groups over three consecutive surveys.

METHODS: A longitudinal cohort study was carried out from the years of 1997 till 2005, collecting interview data from children who were sampled to be representative of Danish schoolchildren. BP was defined overall and specifically in the three spinal regions as having reported pain within the past month. The prevalence estimates and the various patterns of BP reporting over time are presented as percentages.

RESULTS: Of the 771 children sampled, 62%, 57%, and 58% participated in the three back surveys and 34% participated in all three. The prevalence estimates for children at the ages of 9, 13, and 15, respectively, were for BP 33%, 28%, and 48%; for LBP 4%, 22%, and 36%; for MBP 20%, 13%, and 35%; and for NP 10%, 7%, and 15%. Seeking care for BP increased from 6% and 8% at the two youngest ages to 34% at the oldest. Only 7% of the children who participated in all three surveys reported BP each time and 30% of these always reported no pain. The patterns of development differed for the three spinal regions and between genders. Status at the previous survey predicted status at the next survey, so that those who had pain before were more likely to report pain again and vice versa. This was most pronounced for care-seeking.

CONCLUSION: It was confirmed that BP starts early in life, but the patterns of onset and development over time vary for different parts of the spine and between genders. Because of these differences, it is recommended to report on BP in youngsters separately for the three spinal regions, and to differentiate in the analyses between the genders and age groups. Although only a small minority reported BP at two or all three surveys, tracking of BP (particularly NP) and care seeking was noted from one survey to the other. On the positive side, individuals without BP at a previous survey were likely to remain pain free at the subsequent survey.

Background

It is well known that back pain (BP) is a common and costly problem in the general population. Previously, BP in children was considered rare and a sign of a potentially serious disorder [1,2]. Today, according to a recent systematic review, the general opinion would be that BP, including low back pain (LBP), mid back pain (MBP) and neck pain (NP), starts already early in life to accelerate during the early teens up till early adulthood [3] and that its presence in young age is a precursor for BP also in adulthood [4]. In order to approach the issues of prevention and treatment it is helpful to understand the extent and course of a disease, particularly around the time of its onset and that picture is, presently, far from clear. Methodological and definition issues can partly explain this [3]. However, this is also a question of the study objectives and design. It is therefore not surprising that the estimates from various studies vary and that often they make no sense. Also, there appears to be no credible data on the true incidence for each spinal region in young people.

(more…)

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Predictors of Outcome in Neck Pain Patients

By Frank M. Painter|August 25, 2012|Chiropractic Care, Chronic Pain, Neck Pain, Radiculopathy, Spinal Manipulation|

Predictors of Outcome in Neck Pain Patients Undergoing Chiropractic Care: Comparison of Acute and Chronic Patients

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2012 (Aug 24); 20 (1): 27

Cynthia K Peterson, Jennifer Bolton, B. Kim Humphreys

University of Zürich and Orthopaedic University Hospital Balgrist, Forchstrasse 340, 8008 Zürich, Switzerland

Background Neck pain is a common complaint in patients presenting for chiropractic treatment. The few studies on predictors for improvement in patients while undergoing treatment identify duration of symptoms, neck stiffness and number of previous episodes as the strong predictor variables. The purpose of this study is to continue the research for predictors of a positive outcome in neck pain patients undergoing chiropractic treatment.

Methods Acute (< 4 weeks) (n = 274) and chronic (> 3 months) (n = 255) neck pain patients with no chiropractic or manual therapy in the prior 3 months were included. Patients completed the numerical pain rating scale (NRS) and Bournemouth questionnaire (BQ) at baseline prior to treatment. At 1 week, 1 month and 3 months after start of treatment the NRS and BQ were completed along with the Patient Global Impression of Change (PGIC) scale. Demographic information was provided by the clinician. Improvement at each of the follow up points was categorized using the PGIC. Multivariate regression analyses were done to determine significant independent predictors of improvement.

Results Baseline mean neck pain and total disability scores were significantly (p < 0.001and p < 0.008 respectively) higher in acute patients. Both groups reported significant improvement at all data collection time points, but was significantly larger for acute patients. The PGIC score at 1 week (OR = 3.35, 95% CI = 1.13-9.92) and the baseline to 1 month BQ total change score (OR = 1.07, 95% CI = 1.03-1.11) were identified as independent predictors of improvement at 3 months for acute patients. Chronic patients who reported improvement on the PGIC at 1 month were more likely to be improved at 3 months (OR = 6.04, 95% CI = 2.76-13.69). The presence of cervical radiculopathy or dizziness was not predictive of a negative outcome in these patients.

CONCLUSIONS: The most consistent predictor of clinically relevant improvement at both 1 and 3 months after the start of chiropractic treatment for both acute and chronic patients is if they report improvement early in the course of treatment. The co-existence of either radiculopathy or dizziness however do not imply poorer prognosis in these patients.

There are more articles like this @ our:

Chronic Neck Pain and Chiropractic Page and the

A Clinical Model for the Diagnosis and Management Page

From the FULL TEXT Article:

Background

Patients suffering from neck pain are second only to low back pain patients in terms of the frequency of presentation for chiropractic treatment [1-4]. For many of these patients the precise diagnosis is difficult to ascertain and thus becomes labeled ‘non-specific’ neck pain or neck pain from mechanical dysfunction [1,3-5]. Research evidence has yet to determine with clarity whether spinal manipulative therapy (SMT) or mobilization of the neck is the superior treatment for these patients [1-9] although it appears that both of these treatments have better outcomes when combined with exercise [5,10]. (more…)

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Neck and Back Pain in Children: Prevalence and Progression Over Time

By Frank M. Painter|June 19, 2012|Low Back Pain, Neck Pain, Pediatrics|

Neck and Back Pain in Children:
Prevalence and Progression Over Time

The Chiro.Org Blog

SOURCE: BMC Musculoskelet Disord. 2011 (May 16); 12: 98 ~ FULL TEXT

Per Kjaer, Niels Wedderkopp, Lars Korsholm, and
Charlotte Leboeuf-Yde

Institute of Sports Science and Clinical Biomechanics,
Part of Clinical Locomotion Network,
University of Southern Denmark,
Campusvej 55, DK-5230, Odense, Denmark.

The following article appears to be the first study to track and review the progression of back pain in the same group of children, over a prolonged period, to see how (or if) it is a contributor to those same complains in adulthood.

Of particular interest is Table 2, because it breaks down and tracks complaints of either neck, mid back, or low back pain in the same group of children at 3 different time periods: ages 9, 13 and 15 years old.

Table 2: Prevalence rates of different types of back pain in a cohort of Danish children/ adolescents surveyed at three time points

Age Group	Age 9	Age 13	Age 15
Neck Pain
All children Boys Girls	10%9%11%	7%5%9%	15%13%18%
Mid Back Pain
All children Boys Girls	20%22%19%	13%13%13%	28%22%32%
Low Back Pain
All children Boys Girls	33%32%34%	28%26%30%	48%39%54%

The Abstract and Full Text Article: (more…)

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Upper Back and Thoracic Spine Trauma

By Frank M. Painter|May 29, 2012|Chiropractic Care, Diagnosis, Evaluation & Management, Neck Pain, Spinal Manipulation|

Upper Back and Thoracic Spine Trauma

The Chiro.Org Blog

Clinical Monograph 23

By R. C. Schafer, DC, PhD, FICC

Upper-thoracic spasms and trigger points are common within the milder complaints heard in a chiropractic office. Typical posttraumatic injuries of the posterior thorax involve the large posterior musculature, thoracic spine, spinocostal joints, and tissues supporting and mobilizing the scapula (especially the rhomboids). Upper right abdominal quadrant ailments (eg, gallbladder, liver) commonly refer pain and sometimes tenderness to the right scapular area.

BACKGROUND

Severe biomechanical lesions of the thoracic spine are seen less frequently than those of the cervical or lumbar spine. But when they occur, they may be serious if related to disc protrusion or a dynamic facet defect. Shoulder girdle, rib cage, spinal cord, cerebrospinal fluid flow, and autonomic visceral problems originating in the thoracic spine are far from being scarce. Common biomechanical concerns are the prevention of thoracic hyperkyphosis, flattening, or twisting, as each can be suspected to contribute to both local and distal, acute and chronic possibly health-threatening manifestations.

Thoracic Fixations

The study of the thoracic spine is often perplexing. It was Gillet’s opinion that many fixations found in the thoracic spine were secondary (compensatory) to focal lesions in either the upper cervical spine or the sacroiliac joints. Thus, a maze of potential variables exists. Empiric evidence has suggested that many thoracic problems have their origin in its base, the lumbar spine or lower, while others are reflections of cervical reflexes. Also, a thoracic lesion may manifest symptoms in either the cervical or the lumbar spine. Foremost in an examiner’s thoughts should be the recognition that the thoracic spine is the structural support and sympathetic source for the esophagus, heart, bronchi, lungs, diaphragm, stomach, liver, gallbladder, pancreas, spleen, kidneys, and much of the pelvic contents. Referred pain and tenderness from these organs to the spine are common.

Screening Thoracic Vertebral Fractures (more…)

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For Neck Pain, Chiropractic and Exercise Are Better Than Drugs

By Frank M. Painter|January 13, 2012|Chiropractic Care, Neck Pain|

For Neck Pain, Chiropractic and Exercise Are Better Than Drugs

The Chiro.Org Blog

SOURCE: The New York Times ~ 1-03-12

By ANAHAD O’CONNOR

Seeing a chiropractor or engaging in light exercise relieves neck pain more effectively than relying on pain medication, new research shows.

The new study is one of the few head-to-head comparisons of various treatments for neck pain, a problem that affects three quarters of Americans at some point in their lives but has no proven, first-line treatment. While many people seek out spinal manipulation by chiropractors, the evidence supporting its usefulness has been limited at best.

But the new research, published in The Annals of Internal Medicine, found that chiropractic care or simple exercises done at home were better at reducing pain than taking medications like aspirin, ibuprofen or narcotics.

“These changes were diminished over time, but they were still present,” said Dr. Gert Bronfort, an author of the study and research professor at Northwestern Health Sciences University in Minnesota. “Even a year later, there were differences between the spinal manipulation and medication groups.”

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. In some cases the pain and stiffness crop up without explanation, and treatment options are varied. Physical therapy, pain medication and spinal manipulation are popular options, but Dr. Bronfort was inspired to carry out an analysis because so little research exists. (more…)

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A Systematic Review and Meta-analysis of Efficacy, Cost-effectiveness, and Safety of Selected Complementary and Alternative Medicine for Neck and Low-back Pain

By Frank M. Painter|January 2, 2012|Low Back Pain, Neck Pain, Spinal Manipulation|

A Systematic Review and Meta-analysis of Efficacy, Cost-effectiveness, and Safety of Selected Complementary and Alternative Medicine for Neck and Low-back Pain

The Chiro.Org Blog

SOURCE: Evid Based Complement Alternat Med [Epub 2011 Nov 24]

Andrea D. Furlan, Fatemeh Yazdi, Alexander Tsertsvadze, * Anita Gross, Maurits Van Tulder, Lina Santaguida, Joel Gagnier, Carlo Ammendolia, Trish Dryden, Steve Doucette, Becky Skidmore, Raymond Daniel, Thomas Ostermann, and Sophia Tsouros

Clinical Epidemiology Methods Centre,
Ottawa Hospital Research Institute,
University of Ottawa Evidence-Based Practice Center,
Box 208, Ottawa, ON, Canada K1H 8L6

Background: Back pain is a common problem and a major cause of disability and health care utilization.

Purpose: To evaluate the efficacy, harms, and costs of the most common CAM treatments (acupuncture, massage, spinal manipulation, and mobilization) for neck/low-back pain.

Data Sources: Records without language restriction from various databases up to February 2010.

Data Extraction: The efficacy outcomes of interest were pain intensity and disability.

Data Synthesis: Reports of 147 randomized trials and 5 non-randomized studies were included. CAM treatments were more effective in reducing pain and disability compared to no treatment, physical therapy (exercise and/or electrotherapy) or usual care immediately or at short-term follow-up. Trials that applied sham-acupuncture tended towards statistically non-significant results. In several studies, acupuncture caused bleeding on the site of application, and manipulation and massage caused pain episodes of mild and transient nature.

Conclusions: CAM treatments were significantly more efficacious than no treatment, placebo, physical therapy, or usual care in reducing pain immediately or at short-term after treatment. CAM therapies did not significantly reduce disability compared to sham. None of the CAM treatments was shown systematically as superior to one another. More efforts are needed to improve the conduct and reporting of studies of CAM treatments.

Introduction:

Back pain is a general term that includes neck, thoracic, and lower-back spinal pain. In the majority of cases, the aetiology of back pain is unknown and therefore is considered as “nonspecific back pain”. Back pain is considered “specific” if its aetiology is known (e.g., radiculopathy, discogenic disease). Although back pain is usually self-limited and resolves within a few weeks, approximately 10% of the subjects develop chronic pain, which imposes large burden to the health-care system, absence from work, and lost productivity [1]. In a recent study, the direct costs of back pain related to physician services, medical devices, medications, hospital services, and diagnostic tests were estimated to be US$ 91 billion or US$ 46 per capita [2]. Indirect costs related to employment and household activities were estimated to be between US$ 7 billion and US$ 20 billion, or between US$25 and US$ 71 per capita, respectively [3–5]. One study published in 2007 showed that the 3-month prevalence of back and/or neck pain in USA was 31% (low-back pain: 34 million, neck pain: nine million, both back and neck pain: 19 million) [6]. (more…)

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