Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders

In efforts to improve the understanding, prevention, treatment and especially the economic impact of costly spine related disorders, an international Task Force was established in 2000 to specifically study neck pain and its associated disorders. The intention of this comprehensive 10 year study was to attain a more indepth understanding of the impact and ultimate management of one of the leading economic and physically disabling health burdens.

Several factors demonstrate the significance of this study for chiropractic patients.
Primarily is the synthesis of a comprehensive long term study whos intended outcome is to determine an authority on the treatment, prevention and management of these conditions. To that end, of the 5-member executive committee and 13-member scientific secretariat, the director of the entire study is Scott Haldeman, DC, MD, PhD. Dr. Haldeman is a leading neurologist and chiropractor. Among the other committee leaders, 6 hold chiropractic degrees. In other words, the chirorpactic profession is not only well represented in a most authoritative study, but the findings are overall very positive for chiropractic.

The results of the Bone and Joint Decade 2000-2010 Task Force on neck pain and its associated disorders shows that spinal related pain and disorders are a significant and overwhelming problem worldwide. Published earlier this year in the journal Spine, this comprehensive report culminated findings from seven years of work from 9 contries and over 50 leading researchers. Ultimately after reviewing over 31,000 citations and a number of original research projects that were conducted within the task force, the key findings "are overall very positive for the chiropractic profession".

The reality of neck pain prognosis is that most people with neck pain do not experience a complete resolution of symptoms, and 50% to 85% of those who experience neck pain at some time will report it again 1 to 5 years later.
Of importance is that mobilization, manual therapy, exercis and low-level laser therapy appeared to be more beneficial forms of treatment.

However, after scrutinizing the hundreds of different treatment options and products available, it was determined that no method is clearly superior to any other. Although it was clear that interventions that focused on regaining function and mobilization were relatively more effective that interventions that did not have such a focus.

Overall it demonstrated that chiropractic remains one of the most highly utilized and effective forms of care. The ultimate consensus determines that mobilization of joints and realted tissues is the most effective and restoritive means of therapy and recovery. Yet considering the complexities of the conditions, treatment options will remain varied and it is recommended that individuals consider the different options and what may be most individually appropriate.

For more indepth information or offprints of the studies, please contact Dr. Wilson.

Healthcare expenditures for neck and back pain and for work related injuries have escalated so much (8-fold increase) over the past year that the revision of the American College of Occupational and Envirionmental Medine's (ACOEM) recommendation of chiropractic manipulation in the guidelines of treatment is yet further testimony to the benefits of chiroprctic care.

Although in the past, the ACOEM has not recognized chiropractic, the recent (2008) revision of the Occupational Medicine Practice Guidelines recommends manipulation for chronic, persistent low back or neck pain and for cervicogenic headaches. This is a significant step for public perception and the improved understanding of the benefits of chiropractic. With so many treatment options to chose from, and many with adverse side effects, it has always been a challenge to provide compelling evidence for patients unfamiliar with chiropractic, to trust a chiropractic care regimen.

While many individuals rely on chiropractic with certainty, many are not aware of the help it offers. The guidelines, based on over 1,500 references and 546 well designed studies, were developed by a multidisciplinary panel which was reviewd by leading health and medical organizations. This translates into the increasing validity and evidence for encouraging not only improved information regarding the benefits of chirorpactic, but the potential for better reimbursement.

The guidelines recommend courses of manipulation treatments for chronic persistent low back pain and include a regimen of follow-up treatments to maintain at-work status. It also states that manipulation for recurrent exacerbations (re-injury or flare-ups) is of benefit and considered effective. This is also significant, because it states that not only is the initial acute phase of treatment important, but maintaining the improvement as well as repeated use of manipulation is also declared as a recommendation. Of course treatment recommendations are coordinated with strengthening and exercise. Other treatment considerations are to change to alternative forms of manipulation (such as different techniques or providers) should the response not result in favorable progress before completely discontinuing the manipulation program.

Recommendation for treatment of cervicogenic (related to the joints and muscles of the neck) headaches are also described and consideration of continued treatments should be based on objective improvement and functional progress.

As described in the Bone and Joint Task Force, one of the most important findings of the study, and equally relevant here, is that finding a provider you feel most comfortable with is important to the outcome and results. More patients are finding the results of their chiropractic care of benefit, and it is great to have more substantial validation come about to provide more helpful recommendations.