491- Spinal Adjustments for Acute Neck Pain: Efficacy, Safety, and Clinical Takeaways

Welcome to the Evidence Based Chiropractor where each week we deliver the latest chiropractic research and marketing strategies all in the time it takes to get to your office. Now here's your host, Dr. Jeff Langmaid.

Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. On today's episode, we are back with more brand new research and this one is all about the efficacy and safety of spinal adjustments for the management of acute neck pain. Great study, lot of take home messages, clinical pearls and communication points that we will get into on today's episode. Now before we get started, if you want to use research just like this to bridge the gap and build relationships with other healthcare providers in your community, head over to the evidencebasedchiropractor.com and get started with the MD connection. For less than a hundred bucks, you're gonna get everything you need to start the process of building relationships. And if you're listening to this podcast and you're not yet a member, what are you doing? This is an absolute no brainer, super cost effective and just a really good thing to do if you wanna take care of more people in your community. So, so learn more and get started over at the evidence basedchiropractor.com but as I said at the top on today's episode, we're talking research and we're diving into a brand new systematic review and meta analysis that takes a really close look at spinal manipulative therapy. Spinal Adjustments for Acute Neck Pain. I'll drop a link down in the show. Notes came out in 2025. The official title is Efficacy and Safety of Spinal Manipulative Therapy and in the Management of Acute Neck Pain. A Systematic Review and Meta Analysis. Again, this came out in 2025. It was published in systematic reviews and it evaluated eight RCTs, randomized controlled trials involving nearly 1,000 patients to assess the efficacy and safety of spinal adjustments in managing acute neck pain. So if you're taking care of patients that have neck pain, whether it's whiplash, sports injuries, sudden onset mechanical neck pain, this episode is one you're gonna wanna pay attention to. Well, why? We start with the fact that neck pain is super common in chiropractic practices. Matter of fact, neck Pain is the fourth leading cause of disability worldwide, affecting over 30% of people annually. That means there are literally billions of people on planet earth struggling with neck pain. The beauty of that, many do not need advanced interventions or surgical or surgery. What they do need is your care. They need movement Based care, coaching, exercise, rehab and adjustments get those segmental joints moving appropriately is a massive step in the right direction. They need your care as big billions of people. Now, acute neck pain, they call nap in this study is really, really common with patients experiencing debilitating pain and loss of function. And on occasion it can progress to chronic pain if it's not managed effectively. And despite this prevalence, the fact that it is super common, treatment guidelines have varied, especially regarding the use of spinal adjustments. And this is really important because when you think about neck pain, you think about somebody just waking up with a crick in their neck, right? That changes their day. While it might not be the most on the surface level debilitating thing, it really changes people's day. And when a day becomes change and then that becomes a week and then that becomes a month, this is where we start to see the real impact. When acute neck pain becomes chronic and mobility is limited, you have to remember that it's not just that they're holding their neck in a weird position, it's that they're unable to function as a human being appropriately. What do I mean? Our vestibular system is attached to our sight to a certain degree, our ability to level and know where we are in space. A lot of this requires for optimization. It requires the best mobility possible. And in acute neck pain, when somebody is not moving appropriately or at all, it really changes. It has a massive life impact, is what I'm trying to say. So when you see somebody with neck pain, while again it might not come off as the most five alarm fire type situation, it's important to realize that even acute neck pain of short duration can massively impact your patient's life day in and day out. Now, the other side of the coin is when you get in there and deliver your care, you deliver an adjustment and they immediately in many cases begin moving better. That's massive impact, that's opportunity, right then to get those referrals, get those testimonials, and really encourage people along that process. So this study specifically consolidates data from multiple randomized control trials. And the goal was to provide clarity on how spinal adjustments affect pain, affect cervical range of motion, and affect disability levels with people that have acute neck pain. So there were eight randomized control trials analyzed, again involving 965 patients. So nearly 1,000 patients with acute neck pain in a classic sense lasting less than three months. Patients received either spinal adjustments, cervical, thoracic or first rib or the other group was the controlled treatment that was exercise, a sham adjustment or medication the outcome measures that were analyzed include pain intensity using vas, cervical range of motion or disability using an ndi. So the key findings. Let's dive in. Pain reduction, that was really the primary outcome here. And they highlighted the fact that spinal adjustments significantly. Love to see that word in the research because there's meaning behind it. Significantly reduced pain intensity compared to control treatments. This finding was statistically significant. Love to see that as well. Indicating that patients receiving spinal adjustments experience clinically relevant pain relief. All of that is great information. One quote from the study that stuck out SMT demonstrated significant efficacy in reducing pain intensity in patients with neck pain with an overall reduction of 1.53 points on a 10 point scale. That's an average overall reduction of 15%. That is meaningful. And when you see those words statistically significant, clinically relevant, those are the keywords we're always looking for in the literature that really highlight, just, or substantiate, I should say, the proof of the result. So beautiful Outcomes here, highlighting the benefits of what you do and what you provide. Let's move on to those secondary outcomes. And the secondary outcome first is range of motion. They found that spinal adjustments were also effective in improving cervical range of motion in all measured aspects. In flexion, in extension, in lateral left flexion, in lateral right flexion, in left rotation, in right rotation. All of that data indicated that the spinal adjustments delivered improved neck mobility significantly. That word again over across all planes of motion. Now this makes sense. This is probably the easiest to think of because you have a joint that's not moving appropriately, that has segmental dysfunction. You get in there, you deliver an adjustment. Our expectation is that it's going to be moving more fluidly. If there's a restriction, that restriction is going to be reduced or eliminated. So I think all of us think of these as foregone conclusions, but. But it doesn't mean we should hop over it in our process. And this is important. We're stacking these improvements and these outcomes right now. So we've proven average 15% reduction in pain. Now we're showcasing the fact that there's about a 8 to 10, 8 to 12 degree improvement in range of motion pending which plane. And now let's move into disability. Spinal adjustments also led to significant reductions in disability as measured by an NDI or an NPQ. The mean difference was over 6 on a 10 point scale. This was also statistically significant, suggesting that spinal adjustments not only reduce pain, but restore function and daily activity capacity and pain. As I always like to say, it's the Truth is the last thing to come and the first thing to go. People live with pain forever. It's when the pain impacts their life enough that life impact or life effect, that then they make the decision to move forward and seek care. So while we started with pain relief as the primary outcome measure, we moved into range of motion. Disability might be the most important one. Disability, this ability sounds super clinical. So I'm gonna exchange that for life impact and life effect. When somebody's life, as they say, restored function, improved daily activity capacity, when somebody gets back to doing the things that they wanna do, that's the win. That's why they're showing up, that's why they chose you, that's why they're going through the care plan, whatever that might be, is to get back to what they were doing before is the restriction on whatever that thing is. Professional athlete, maybe it's playing a game. An older adult, maybe it's trying to enjoy golf on the weekends. Maybe he's trying to make it through the day without having to pop a medication. Whatever that life impact and life effect is for each individual and it might be different for a lot of different people in your practice. When you can meaningfully decrease disability and get them back, overcome that life impact and that life effect, that is the massive win. That's why people are coming to see you. And yes, if they're moving better, improves range of motion, if they're feeling better, decreased pain, the those are awesome components. But people will often live again with a little bit of pain or a little bit of restriction if they can get back. And they'll view it as a massive win if and when they get back to those life impact activities. So asking the questions of that impact is really, really important up front because it sets the stage and the guidelines for what you're trying to accomplish with that patient. This study also highlighted safety and there were no serious adverse events at all. And the quote was, spinal adjustments were well tolerated with minimal and self limiting adverse events, if any. The findings support the safety of SMT for neck pain management. So what are some clinical takeaways here? Well, one is that this study provides extremely strong and compelling evidence that spinal adjustments should be considered as a first line treatment for acute neck pain, particularly when targeting pain reduction in and range of motion improvements. Now, the adjustments were applied to the cervical spine, the thoracic spine and the first rib. Why cervical spine? Well, direct pain reduction and mobility. Thoracic spine because it's really beneficial when there's referred neck pain or postural issues. And first rib, because there can be cervicogenic symptoms and scapular dysfunction affecting that. So important to keep that in mind as you're going through. I always like to say, look at the next joint. If somebody has shoulder pain, you should be looking at the elbow and the neck. You should always look at those adjacent joints. Don't become too myopic. So when somebody presents with neck pain, don't only check the cervical spine. Make sure you're checking the thoracic spine, make sure you're checking the first rib. Ensure that everything is moving fluidly in the way you'd like to see. So also combining spinal adjustments and exercise. This again continues to emphasize the synergistic effects of, of combining spinal adjustments with targeted neck exercises, which is probably what you're doing in your practice. But this reinforces that further. So communicating this to your patients, really, really important and just highlighting that, you know, what we do here is not only about relieving pain, it's about improving your mobility and helping you get back to those things that you'd like to in your life. Insert that thing here, right? Another big takeaway is that chiropractic care is safe, effective for people with acute neck pain. It can and should be a first line treatment. And also that the research shows spinal adjustments can reduce neck pain by over 15%, comparable or better to medications without any of the risks associated. That's a powerful statement that I highly encourage you to verbalize to your new patients, your existing patients. Get out there on social media. What also does this mean? This is a great study. We're gonna highlight this in the future for MD Connection for all of our docs looking to bridge the gap and build referral relationships. This is a perf bridge building study because it highlights the safety and efficacy of what we do with a very, very common. We're talking acute neck pain, a super common thing that doctors all over your town are seeing all day, every day. And if I'm just blunt about it, many of them are making really, really poor decisions. How do I know that? Because we still see people moving from acute to chronic pain, only being prescribed medication, having injections, advanced interventions, elective surgeries before even chiropractic has been attempted. That's nonsense. But it's not. You can't fault the individuals if you're not taking action in your community to get out there. So if you really wanna help people, and again, I'll be direct and serious with you if you believe that you are there to help the people in your community, and you're not looking and working towards bridging the gap with other healthcare providers, at least on a monthly basis. I question it because the actions don't follow the mission. And if your mission is out there to help as many people as possible in your community live the healthiest life, you have to look towards these other healthcare providers that are going to see a lot of people who may never come in to see you unless they get that referral. It's worth it 100% of the time to work to bridge the gap and build those relationships because it gives you access to a completely different pool of people. About 15 to 20% of people have seen a chiropractor or will see a chiropractor of their natural in their own volition or disposition. That means there's literally 80% of the market minimum I think is probably closer to 90% that won't unless they get referred by a friend or their doctor. And I can tell you the people who come over to your practice referred by other healthcare providers come in ready to accept care. They don't come in as skeptic. So I'll get off my soapbox on building referral relationships, but this study is a perfect example of how that can work. And before we wrap up, I wanna say a few words about turncloud. Turncloud is a EHR where no user man is necessary. So head over to turncloud.com, schedule a time to chat with their team. It is a really really slick system that is super easy. So if you're looking for something that is easy to use, easy to implement and gets the job done without getting in your way but facilitating things turncloud turncloud.com also additionally, I am super happy and proud to announce that Leander Tables, one of the oldest, best, most trusted names in chiropractic tables, is coming out as a partner of the Evidence Based Chiropractor. There'll be more news about that very very soon. But if you're interested in a table and you visit Leander, don't hesitate to let them know you heard about them on this podcast. If you have not left a rating or review, I would love it if you would do so. Scroll on down, tap how many stars, leave a line or two of feedback. That would be awesome. And I just want to say thank you for being a chiropractor. Have a fantastic week in practice and I will talk to you soon.

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