Upper Cervical Adjusting

Clinical Outcomes and Patient Satisfaction

By Frank M. Painter|February 24, 2016|Adverse Events, Patient Satisfaction, Upper Cervical Adjusting|

Symptomatic Reactions, Clinical Outcomes and Patient Satisfaction Associated with
Upper Cervical Chiropractic Care: A Prospective, Multicenter, Cohort Study

SOURCE: BMC Musculoskelet Disord. 2011 (Oct 5); 12: 219

Kirk Eriksen, Roderic P Rochester, and Eric L Hurwitz

Chiropractic Health Institute, PC
2500 Flowers Chapel Road
Dothan, AL 36305, USA.

BACKGROUND: Observational studies have previously shown that adverse events following manipulation to the neck and/or back are relatively common, although these reactions tend to be mild in intensity and self-limiting. However, no prospective study has examined the incidence of adverse reactions following spinal adjustments using upper cervical techniques, and the impact of this care on clinical outcomes.

METHODS: Consecutive new patients from the offices of 83 chiropractors were recruited for this practice-based study. Clinical outcome measures included:
1) Neck pain disability index (100-point scale),
2) Oswestry back pain index (100-point scale),
3) 11-point numerical rating scale (NRS) for neck, headache, midback, and low back pain,
4) treatment satisfaction, and
5) Symptomatic Reactions (SR).

Data were collected at baseline, and after approximately 2 weeks of care. A patient reaching sub-clinical status for pain and disability was defined as a follow-up score <3 NRS and <10%, respectively. A SR is defined as a new complaint not present at baseline or a worsening of the presenting complaint by >30% based on an 11-point numeric rating scale occurring <24 hours after any upper cervical procedure.

RESULTS: A total of 1,090 patients completed the study having 4,920 (4.5 per patient) office visits requiring 2,653 (2.4 per patient) upper cervical adjustments over 17 days. Three hundred thirty- eight (31.0%) patients had symptomatic reactions (SRs) meeting the accepted definition. Intense SR (NRS ≥8) occurred in 56 patients (5.1%). Outcome assessments were significantly improved for neck pain and disability, headache, mid-back pain, as well as lower back pain and disability (p <0.001) following care with a high level (mean = 9.1/10) of patient satisfaction. The 83 chiropractors administered >5 million career upper cervical adjustments without a reported incidence of serious adverse event.

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Craniocervical Chiropractic Procedures – A Précis of Upper Cervical Chiropractic

By Frank M. Painter|August 9, 2015|Chiropractic Care, Upper Cervical Adjusting|

Craniocervical Chiropractic Procedures – A Précis of Upper Cervical Chiropractic

The Chiro.Org Blog

SOURCE: J Can Chiropr Assoc 2015 (Jun); 59 (2): 173–192 ~ FULL TEXT

H. Charles Woodfield, III, BPhm, DC, Craig York, DC.
Roderic P. Rochester, DC, Scott Bales, DC,
Mychal Beebe, DC, Bryan Salminen, DC,
Jeffrey N. Scholten, DC .

Director of Research –
Upper Cervical Research Foundation,
Minneapolis, MN

Presented here is a narrative review of upper cervical procedures intended to facilitate understanding and to increase knowledge of upper cervical chiropractic care. Safety, efficacy, common misconceptions, and research are discussed, allowing practitioners, chiropractic students, and the general public to make informed decisions regarding utilization and referrals for this distinctive type of chiropractic care. Upper cervical techniques share the same theoretical paradigm in that the primary subluxation exists in the upper cervical spine. These procedures use similar assessments to determine if spinal intervention is necessary and successful once delivered. The major difference involves their use of either an articular or orthogonal radiograph analysis model when determining the presence of a misalignment. Adverse events following an upper cervical adjustment consist of mild symptomatic reactions of short-duration (< 24-hours). Due to a lack of quality and indexed references, information contained herein is limited by the significance of literature cited, which included non-indexed and/or non-peer reviewed sources.

KEYWORDS: adverse events; atlas; cervical; chiropractic; chiropractic adjustment; craniocervical

From the Full-Text Article:

Introduction:

The indexed literature reports the existence of many upper cervical (UC) procedures. [1, 2] Presented here is a brief narrative review or narrative description of upper cervical techniques (UCT) with the intention of increasing knowledge and understanding regarding their effectiveness and utilization. Procedural similarities and differences between UCT are examined. As chiropractic goes the way of other healing professions through stratification into specialties, this characterization of upper cervical procedures can create appreciation and clarity both inside and outside the profession.

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Case Report of a Patient Presenting With Post-concussion Syndrome and Post-traumatic Stress Disorder

By Frank M. Painter|May 22, 2015|Concussion, Post-traumatic Stress Disorder, Upper Cervical Adjusting|

A Case Report on the Management of a Patient Presenting With Post-concussion Syndrome and Post-traumatic Stress Disorder, Using the Upper Cervical Chiropractic Technique

The Chiro.Org Blog

SOURCE: Topics in Integrative Health Care 2015 (Mar 31); 6 (1)

Scott Bales, DC

180 Parsons Rd #11
Alliston, Ontario,
Canada L9R1E8

Introduction: This case report describes the chiropractic management of a patient with a history of multiple mild traumatic brain injuries, using Upper Cervical manipulative technique.

Clinical Features: A 42 year old man presenting with symptoms of post-concussion syndrome, and diagnosed with post-traumatic stress disorder and depression.

Intervention and Outcome: The Kale Upper Cervical Procedure was utilized to assess, monitor, and correct the effects of an upper cervical subluxation in a patient over an 8 week period. The patient reported significant improvement in symptoms of post- concussion syndrome, and small positive improvements in PTSD symptoms. Follow up at 11 months showed continued improvement in most symptoms.

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Symptomatic Reactions, Clinical Outcomes and Patient Satisfaction

By Frank M. Painter|August 16, 2012|Patient Satisfaction, Safety, Upper Cervical Adjusting|

Symptomatic Reactions, Clinical Outcomes and Patient Satisfaction Associated with Upper Cervical Chiropractic Care: A Prospective, Multicenter, Cohort Study

The Chiro.Org Blog

SOURCE: BMC Musculoskelet Disord. 2011 (Oct 5); 12: 219

Kirk Eriksen, Roderic P Rochester, and Eric L Hurwitz

Chiropractic Health Institute, PC, Clinic Director, 2500 Flowers Chapel Road, Dothan, AL 36305, USA. drkirke@graceba.net

BACKGROUND: Observational studies have previously shown that adverse events following manipulation to the neck and/or back are relatively common, although these reactions tend to be mild in intensity and self-limiting. However, no prospective study has examined the incidence of adverse reactions following spinal adjustments using upper cervical techniques, and the impact of this care on clinical outcomes.

METHODS: Consecutive new patients from the offices of 83 chiropractors were recruited for this practice-based study. Clinical outcome measures included:

Neck pain disability index (100-point scale),
Oswestry back pain index (100-point scale),
11-point numerical rating scale (NRS) for neck, headache, midback, and low back pain,
treatment satisfaction, and
Symptomatic Reactions (SR).

Data were collected at baseline, and after approximately 2 weeks of care. A patient reaching sub-clinical status for pain and disability was defined as a follow-up score <3 NRS and <10%, respectively. A SR is defined as a new complaint not present at baseline or a worsening of the presenting complaint by >30% based on an 11-point numeric rating scale occurring <24 hours after any upper cervical procedure.

RESULTS: A total of 1,090 patients completed the study having 4,920 (4.5 per patient) office visits requiring 2,653 (2.4 per patient) upper cervical adjustments over 17 days. Three hundred thirty- eight (31.0%) patients had SRs meeting the accepted definition. Intense SR (NRS ≥8) occurred in 56 patients (5.1%). Outcome assessments were significantly improved for neck pain and disability, headache, mid-back pain, as well as lower back pain and disability (p <0.001) following care with a high level (mean = 9.1/10) of patient satisfaction. The 83 chiropractors administered >5 million career upper cervical adjustments without a reported incidence of serious adverse event.

CONCLUSIONS: Upper cervical chiropractic care may have a fairly common occurrence of mild intensity SRs short in duration (<24 hours), and rarely severe in intensity; however, outcome assessments were significantly improved with less than 3 weeks of care with a high level of patient satisfaction. Although our findings need to be confirmed in subsequent randomized studies for definitive risk-benefit assessment, the preliminary data shows that the benefits of upper cervical chiropractic care may outweigh the potential risks.

From the FULL TEXT Article:

Discussion: (more…)

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Adjusting Increases Upper Cervical Rotation by 100% in 10 Cases of Atlantoaxial Osteoarthritis

By Frank M. Painter|April 1, 2011|Osteoarthritis, Upper Cervical Adjusting|

Adjusting Increases Upper Cervical Rotation by 100% in 10 Cases of Atlantoaxial Osteoarthritis

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2011 (Feb); 34 (2): 131-137

Hong Yu, MD, Shuxun Hou, MD,
Wenwen Wu, MD, Xiaohua He, MD

Department of Orthopedics,
The 1st Affiliated Hospital of the General Military Hospital,
Beijing, China

This new case series, managed by the Department of Orthopedics, in the General Military Hospital of Beijing, China, involved 10 patients with idiopathic degenerative and posttraumatic atlantoaxial osteoarthritis. They were treated with upper cervical chiropractic adjusting, in combination with mobilization device therapy.

Outcome measures included self-reported pain using a numeric pain scale (NPS) (1-10, with 0 is no pain and 10 is the worst possible pain), physical examination findings, and radiologic changes.

The reported results were quite impressive:

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