Jeff LangmaidFounder, The Evidence Based Chiropractor

What Really Impacts Neck Pain Relief? This Study Shows…

25 Oct 2025 · 1 min

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The video presents a secondary analysis of a randomized clinical trial involving roughly 60 patients with chronic neck pain. The trial compared real cervical adjustments to sham adjustments while systematically varying the expectation messages given to patients—positive (promising pain relief), neutral, or negative (warning of possible worsening). Researchers also measured salivary cortisol to assess stress response and recorded each patient’s fear of the adjustment procedure. Using regression modeling, they identified which factors—type of adjustment, expectation framing, cortisol changes, and fear levels—most strongly predicted changes in reported pain. The study highlights how the language clinicians use and patients’ stress and fear can significantly influence treatment outcomes.

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This study was a secondary analysis of a randomized clinical trial. And how about 60 some odd patients with chronic neck pain? Now, in this study, they compared real cervical adjustments with sham adjustments, and they layered in expectation setting. So some patients were told positive things like this will help your pain. Others were told neutral messages, and some were even given negative suggestions like this might make your pain worse. And on top of that, the researchers also measured salivary cortisol levels, our body's stress hormone. And they looked at whether patients fear of adjust influenced the outcomes. And then they ran a regression model to figure out what factors contributed the most to changes in pain. So this is a really cool study. The study design is really nice because it lays out very systematically how does what you say influence what happens.