Neck pain and disability outcomes following chiropractic upper cervical care: a retrospective case series.

OBJECTIVE: To investigate the use of an upper cervical low-force (UCLF) chiropractic procedure, based on a vertebral alignment model, in the management of neck pain and disability by assessing the impact on valid patient outcome measures. DESIGN: A retrospective case series. METHODS: Consecutive patient files at a private chiropractic practice over a 1-year period were reviewed for inclusion. Data for the first visit, pre- and post-adjustment atlas alignment radiographic measurements, baseline and 2-weeks NDI (100 point) and verbal NRS (11 point) were recorded. The data were analyzed in their entirety and by groups comparing <30% vs. >30% post adjustment atlas alignment changes. RESULTS: Statistically significant clinically meaningful improvements in neck pain NRS (P < 0.01) and disability NDI (P < 0.01) after an average of 13.6 days of specific chiropractic care including 5.7 office visits and 2.7 upper cervical adjustments were demonstrated. There were no serious adverse events. Cases with the post-adjustment skull/atlas alignment measurement (atlas laterality) that were changed more than 30% on the first visit toward the orthogonal alignment predicted a statistically and clinically significant better outcome for NDI in 2 weeks. CONCLUSIONS: UCLF chiropractic instrument adjustments utilizing a vertebral alignment model are promising for the management of patients with neck pain based on assessment using valid outcome measures.