CHIROPRACTIC, MEDICATION, AND SELF-CARE FOR NECK PAIN - DESCRIPTION (provided by applicant): Neck pain is very common, with considerable socioeconomic consequences. Despite the public health impact, management of neck pain conditions has been inadequately researched. Systematic reviews have concluded that, although some therapies appear promising, there are too few randomized clinical trials of sufficient quality to support the use of one therapy over another. This is especially true for acute/subacute neck pain. Although commonly treated with prescription medications, neck pain sufferers are increasingly seeking relief through complementary and alternative medicine therapies, like chiropractic spinal manipulation. Little is known, however, about the short- and long-term relative efficacy of these therapies and how they compare to giving patients simple advice on self-care. The broad, long-term objective of this research is to identify effective therapies for neck pain sufferers and to increase our understanding of neck pain conditions. The proposed randomized, observer-blinded clinical trial is a unique collaborative effort by experienced chiropractic and medical researchers and will focus on patients with acute/subacute neck pain (<12 weeks duration). A pilot study recently completed by our investigative team shows that this proposed trial is feasible. The study has the following specific aims: Primary Aim To determine the relative efficacy of chiropractic spinal manipulation, prescription medication, and self-care advice for neck pain in both the short term (after 6 weeks) and long term (after 52 weeks), using patient-rated neck pain as the main outcome measure. Secondary Aims To determine the short- and long-term relative efficacy of the three interventions using the following secondary outcome measures: patient-rated disability, general health, improvement, satisfaction with care, fear avoidance, and over-the-counter medication use. To determine the relative efficacy of the three interventions in terms of cervical spine motion performance measured by examiners blinded to treatment group assignment. This research will help narrow the large gap in the scientific literature regarding the relative efficacy of two commonly used treatments for acute/sub-acute neck pain. It will also provide clinically useful information for health care practitioners, policy makers and, most importantly, those who suffer from this painful and costly condition.
