Chiropractic on
    Chronic Neck Pain
    Chiropractic "Only Proven Effective Treatment"
     for Chronic Whiplash
    Khan S, Cook J, Gargan M, Bannister G. A symptomatic classification of whiplash injury and the
    implications for treatment. Journal of Orthopaedic Medicine 1999;21(1):22-25.
    Executive summary provided by Dr. Dan Murphy, D.C., DABCO

    A new study published in the Journal of Orthopaedic Medicine not only points out the superiority of
    chiropractic care for chronic whiplash patients, but also examines which chronic whiplash patients
    respond best to chiropractic care. The authors begin the paper by explaining that:

    “Conventional medical treatment of patients with whiplash symptoms is disappointing."

    A retrospective study by Woodward et al.(Woodward MN, Cook JCH, Gargan MF, Bannister GC. Chiropractic
    treatment of chronic whiplash injuries. Injury 1996;27:643-645), demonstrated that chiropractic treatment
    benefited 26 of 28 patients suffering from chronic whiplash syndrome.

    The question was not whether chiropractic was beneficial for acute whiplash patients, but to determine which
    patients with chronic whiplash will benefit from chiropractic treatment.

    The authors interviewed 100 consecutive chiropractic referrals for chronic whiplash symptoms, seven of which
    were “lost to follow up". They were able to divide the remaining 93 patients into three symptom groups:

    Group 1: Patients with “neck pain radiating in a ‘coat hanger’ distribution, associated with restricted range of neck
    movement but with no neurological deficit”;

    Group 2: Patients with “neurological symptoms, signs or both in association with neck pain and a restricted range
    of neck movement”;

    Group 3: Patients who described “severe neck pain but all of whom has a full range of motion and no neurological
    symptoms or signs distributed over specific myotomes or dermatomes.” These patients also “described an
    unusual complex of symptoms,” including “blackouts, visual disturbances, nausea, vomiting and chest pain, along
    with a nondermatomal distribution of pain.”

    The patients underwent an average of 19.3 adjustments over the course of 4.1 months (mean). The patients were
    then surveyed and their improvement reported as follows:

    Group 1
    24% - Asymptomatic
    24% - Improved by Two Symptom Grades
    24% - Improved by One Symptom Grade
    28% - No Improvement

    Group 2
    38% - Asymptomatic
    43% - Improved by Two Symptom Grades
    13% - Improved by One Symptom Grade
    6% - No Improvement

    Group 3
    0% - Asymptomatic
    9% - Improved by Two Symptom Grades
    18%- Improved by One Symptom Grade
    64% - No Improvement
    9% - Got Worse

    In their discussion, the authors made these observations:

    Woodward, et al., found improvement in chronic symptoms in 26 of 28 patients (93%) following chiropractic
    treatment. "Our results confirm the efficacy of chiropractic, with 69 of our 93 patients (74%) improving following
    treatment."

    “Our study suggests that such a group of nonresponders does exist, represented by group 3. The defining
    characteristics of patients in this group were the full range of neck movement in association with neck pain,
    bizarre symptoms, female and ongoing litigation. The mean age of the group at 29.5 (16-43) was lower than that
    of the other two groups (mean 36.8, range 18-65)."

    “The results from this study provide further evidence that chiropractic is an effective treatment for chronic
    whiplash symptoms. However, our identification of a group of patients who fail to respond to such treatment,
    highlights the need for a careful history and physical examination before commencing treatment.”