Utilization of chiropractic services in patients with osteoarthritis and spine pain at a publicly funded healthcare facility in Canada: A retrospective study.

BACKGROUND: Osteoarthritis (OA) is one of the most prevalent and disabling musculoskeletal diseases worldwide. There is preliminary evidence from experimental studies and consensus documents that chiropractic management may alleviate spine and/or extremity OA related pain in the short term. OBJECTIVE: This research explores the potential relationship of a pragmatic course of care, including soft tissue therapy, spinal manipulation, and other treatments commonly delivered by chiropractors, to spine and extremity pain in patients with OA. METHODS: A retrospective analysis of prospectively collected data from the chiropractic program at a publicly funded healthcare facility was conducted. The primary outcome measures for patients diagnosed with spine and/or extremity OA (n= 76) were numeric pain scores of each spinal and extremity region at baseline and discharge, and a change score was determined. RESULTS: Statistically significant improvements that exceed a clinically meaningful difference in pain numeric rating scale scores were demonstrated by point change reductions from baseline to discharge visits. Change scores exceeding a minimally clinically important difference of "2-points" were present in the sacroiliac (-2.91), extremity (-2.84), cervical (-2.73), thoracic (-2.61), and lumbar (-2.59) regions. CONCLUSION: Patients diagnosed with OA in a socioeconomically disadvantaged community demonstrated reductions in mean pain scores in both a clinically meaningful and statistically significant manner concurrent with a course of chiropractic care.

Patient Characteristics and Clinical Outcomes Associated With Conservative Treatment for Spine Pain in Women Experiencing Socioeconomic Challenges.

OBJECTIVE: The purpose of this study was to describe patient demographics and pain changes for women over the course of care in a chiropractic program. METHODS: We performed a retrospective cross-sectional analysis of a prospective quality assurance database from the Mount Carmel Clinic (MCC) in Winnipeg, Manitoba, Canada. Pain scores were reported on an 11-point Numeric Rating Scale. Baseline and discharge Numeric Rating Scale scores were compared for each spinal and extremity region through Wilcoxon signed rank tests to determine if clinically meaningful or statistically significant differences were present. RESULTS: The sample population attained was 348 primarily middle-aged (mean = 43.0, SD = 14.96) women with obesity (body mass index = 31.3 kg/m2, SD = 7.89) referred to the MCC chiropractic program by their primary care physician (65.2%) for an average of 15.6 (SD = 18.49) treatments. Clinically meaningful median baseline to discharge changes in pain by spine region were observed (Cervical = -2, Thoracic = -2, Lumbar = -3, Sacroiliac = -3), each of which yielded statistical significance (P < .001). CONCLUSION: This retrospective analysis found that the MCC chiropractic program serves middle-aged women with obesity experiencing socioeconomic challenges. Pain reductions were reported, regardless of the region of complaint, temporally associated with a course of chiropractic care.