ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
Patterns of initial treatment and subsequent care escalation among medicare beneficiaries with neck pain: a retrospective cohort study.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
2 citing papers in PubMed.
- Efficacy of spinal manipulative therapy in older adults with chronic spinal conditions: an updated systematic review.The Journal of the Canadian Chiropractic Association · 2026Article
- Observational Study of the Safety of Chiropractic vs Medical Care Among Older Adults With Neck Pain.Journal of manipulative and physiological therapeuticsObservational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
purposeTo compare long-term care escalation encounters among three care patterns for new episodes of neck pain among Medicare beneficiaries.
methodsWe examined Medicare claims spanning a four-year period for beneficiaries with new episodes of neck pain beginning in 2019. All patients were continuously enrolled under Medicare parts A, B, and D and aged 65-99 years. We calculated the cumulative frequency and propensity- weighted rate ratios for escalated care encounters across three distinct, index-visit related neck pain treatment cohorts: 1) Spinal manipulative therapy; 2) Primary care without prescription analgesics within 7 days; 3) Primary care with prescription analgesics within 7 days.
resultsWhen compared to the primary care without analgesics cohort, the spinal manipulative therapy cohort was associated with a 64% lower rate (RR 0.36, 95% CI 0.35,0.37) for long-term care escalation encounters, while the primary care with prescription analgesics cohort was associated with an 8% higher rate (RR 1.08; 95% CI 1.05,1.10).
conclusionInitial spinal manipulative therapy was associated with a significant reduction in downstream care escalation encounters among Medicare beneficiaries with new episodes of neck pain. Our study contributes to a growing body of evidence supporting the integration of non-pharmacological care strategies for neck pain management.
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Registered trials
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