ArticleJournal of general internal medicine2018
Comparative Effectiveness of Usual Care With or Without Chiropractic Care in Patients with Recurrent Musculoskeletal Back and Neck Pain.
Article in Journal of general internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cost of chiropractic versus medical management of adults with spine-related musculoskeletal pain: a systematic review.Chiropractic & manual therapies · 2024Pooled it
- The Association of First Provider Seen With Time Loss From Work Among Workers With Back Injury: A Cohort Study.American journal of industrial medicine · 2026Article
- Using propensity score matching for sequential recruitment in multigroup cohort studies.Journal of behavioral medicine · 2026Article
- Musculoskeletal pain among South African flight Attendants: A cross-sectional study.Journal of chiropractic humanities · 2025Article
- Feasibility and effectiveness of telehealth in the management of cervicothoracic and lumbar pain during the first six months of the SARS-CoV-2 pandemic: A case series.Interventional pain medicine · 2023Article
- Factors Influencing Primary Care Providers' Unneeded Lumbar Spine MRI Orders for Acute, Uncomplicated Low-Back Pain: a Qualitative Study.Journal of general internal medicine · 2020Article
- Whole Systems Research Methods in Health Care: A Scoping Review.Journal of alternative and complementary medicine (New York, N.Y.) · 2019Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundChiropractic care is a popular alternative for back and neck pain, with efficacy comparable to usual care in randomized trials. However, the effectiveness of chiropractic care as delivered through conventional care settings remains largely unexplored.
objectiveTo evaluate the comparative effectiveness of usual care with or without chiropractic care for patients with chronic recurrent musculoskeletal back and neck pain. STUDY
designProspective cohort study using propensity score-matched controls.
participantsUsing retrospective electronic health record data, we developed a propensity score model predicting likelihood of chiropractic referral. Eligible patients with back or neck pain were then contacted upon referral for chiropractic care and enrolled in a prospective study. For each referred patient, two propensity score-matched non-referred patients were contacted and enrolled. We followed the participants prospectively for 6 months. MAIN MEASURES: Main outcomes included pain severity, interference, and symptom bothersomeness. Secondary outcomes included expenditures for pain-related health care. KEY
resultsBoth groups' (N = 70 referred, 139 non-referred) pain scores improved significantly over the first 3 months, with less change between months 3 and 6. No significant between-group difference was observed. (severity - 0.10 (95% CI - 0.30, 0.10), interference - 0.07 (- 0.31, 0.16), bothersomeness - 0.1 (- 0.39, 0.19)). After controlling for variances in baseline costs, total costs during the 6-month post-enrollment follow-up were significantly higher on average in the non-referred versus referred group ($1996 [SD = 3874] vs $1086 [SD = 1212], p = .034). Adjusting for differences in age, gender, and Charlson comorbidity index attenuated this finding, which was no longer statistically significant (p = .072).
conclusionsWe found no statistically significant difference between the two groups in either patient-reported or economic outcomes. As clinical outcomes were similar, and the provision of chiropractic care did not increase costs, making chiropractic services available provided an additional viable option for patients who prefer this type of care, at no additional expense.
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Registered trials
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