Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Chiropractic & Manual Therapies
Published in: Chiropractic & Manual Therapies 1/2019

Open Access 01-12-2019 | Neck Pain | Research

Do adverse events after manual therapy for back and/or neck pain have an impact on the chance to recover? A cohort study

Authors: Vesa Tabell, Ina M. Tarkka, Lena W. Holm, Eva Skillgate

Published in: Chiropractic & Manual Therapies | Issue 1/2019

Login to get access

Abstract

Background

Manual therapy is a commonly used treatment for patients with back and neck pain. Studies have shown that manual therapy-related adverse events are mainly short in duration and mild or moderate by their intensity, affecting up to 50% of the patients. If the presence of adverse events has an impact on the chance to recover from back/neck pain is poorly understood. The aim of this study was to investigate if mild or moderate adverse events after manual therapy has an impact on the chance to recover from back/neck pain in men and women.

Methods

A prospective cohort study of 771 patients with at least three treatment sessions in a randomized controlled trial performed in January 2010 – December 2013. Adverse events within 24 h after each treatment were measured with questionnaires and categorized as: no, mild or moderate, based on bothersomeness. Outcome measure was the perceived recovery at seven weeks and at three months follow-up. Odds Ratios (OR) and 95% confidence intervals (CI) were calculated by Logistic regression to investigate the associations between the exposure and outcome, and to test and adjust for potential confounding.

Results

There were no statistically significant associations observed between the experience of mild or moderate adverse events and being recovered at the seven weeks follow-up. The only statistically significant association observed at the three months follow-up was for mild adverse events in men with an OR of 2.44, 95% CI: 1.24–4.80 in comparison to men with no adverse events.

Conclusion

This study indicates that mild adverse events after manual therapy may be related to a better chance to recover in men.

Trial registration

The study is based on data from a trial registered in Current Controlled Trials (ISRCTN92249294).
Literature
1.
Deyo RA. The role of spinal manipulation in the treatment of low Back pain. JAMA. 2017;317(14):1418–9.CrossRef
2.
Tsertsvadze A, Clar C, Court R, Clarke A, Mistry H, Sutcliffe P. Cost-effectiveness of manual therapy for the Management of Musculoskeletal Conditions: a systematic review and narrative synthesis of evidence from randomized controlled trials. J Manip Physiol Ther. 2014;37(6):343–62.CrossRef
3.
Skillgate E, Vingard E, Alfredsson L. Naprapathic manual therapy or evidence-based care for back and neck pain: a randomized, controlled trial. Clin J Pain. 2007;23(5):431–9.CrossRef
4.
Skillgate E, Bohman T, Holm L, Vingård E, Alfredsson L. The long-term effects of naprapathic manual therapy on back and neck pain - results from a pragmatic randomized controlled trial. BMC Musculoskelet Disord. 2010;11:26.CrossRef
5.
Lilje S, Persson UB, Tangen S, Kasamoen S, Skillgate E. Costs and Utilities of Manual Therapy and Orthopedic Standard Care for low-prioritized orthopedic outpatients of working age: a cost consequence analysis. Clin J Pain. 2014;30(8):730–6.CrossRef
6.
Carlesso LC, Gross AR, Santaguida PL, Burnie S, Voth S, Sadi J. Adverse events associated with the use of cervical manipulation and mobilization for the treatment of neck pain in adults: a systematic review. Man Ther. 2010;15(5):434–44.CrossRef
7.
Carnes D, Mars TS, Mullinger B, Froud R, Underwood M. Adverse events and manual therapy: a systematic review. Man Ther. 2010b;15(4):355–63.CrossRef
8.
Paanalahti K, Holm LW, Nordin M, Asker M, Lyander J, Skillgate E. Adverse events after manual therapy among patients seeking care for neck and/or back pain: a randomized controlled trial. BMC Musculoskelet Disord. 2014b;15(1):77.CrossRef
9.
Cagnie B, Vinck E, Beernaert A, Cambier D. How common are side effects of spinal manipulation and can these side effects be predicted? Man Ther. 2004;9(3):151–6.CrossRef
10.
Senstad O, Leboeuf-Yde C, Borchgrevink C. Frequency and characteristics of side effects of spinal manipulative therapy. Spine. 1997;22(4):435–40.CrossRef
11.
Carnes D, Mullinger B, Underwood M. Defining adverse events in manual therapies: a modified Delphi consensus study. Man Ther. 2010a;15(1):2–6.CrossRef
12.
Carlesso LC, Cairney J, Dolovich L, Hoogenes J. Defining adverse events in manual therapy: an exploratory qualitative analysis of the patient perspective. Man Ther. 2011;16(5):440–6.CrossRef
13.
Rajendran D, Bright P, Bettles S, Carnes D, Mullinger B. What puts the adverse in ‘adverse events’? Patients’ perceptions of post-treatment experiences in osteopathy – a qualitative study using focus groups. Man Ther. 2012;17(4):305–11.CrossRef
14.
Hurwitz EL, Morgenstern H, Vassilaki M, Chiang LM. Adverse reactions to chiropractic treatment and their effects on satisfaction and clinical outcomes among patients enrolled in the UCLA neck pain study. J Manip Physiol Ther. 2004;27(1):16–25.CrossRef
15.
Rubinstein S, Knol DL, LeboeufYde C, van Tulder MW. Benign adverse events following chiropractic Care for Neck Pain are Associated with Worse Short-term Outcomes but not worse outcomes at three months. Spine. 2008b;33(25):E950–6.CrossRef
16.
Trott CA, Ruiz Aguila ME, Leaver AM. The clinical significance of immediate symptom responses to manual therapy treatment for neck pain: observational secondary data analysis of a randomized trial. Man Ther. 2014;19(6):549–54.CrossRef
17.
Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther. 2009;14(5):531–8.CrossRef
18.
Indahl A, Holm S. The sacroiliac joint; sensory-motor control and pain In: Vleeming A, Mooney V, Stoeckart R, editors. Movement, Stability & Lumbopelvic Pain; integration of research and therapy: Churchill Livingstone; 2007. p. 104–11.
19.
Ebrahim S, Malachowski C, Kamal el Din M, Mulla SM, Montoya L, Bance S, Busse JW. Measures of patients’ expectations about recovery: a systematic review. J Occup Rehabil. 2015;25(1):240–55.CrossRef
20.
Palmlöf L, Holm LW, Alfredsson L, Skillgate E. Expectations of recovery - a prognostic factor in patients with neck pain undergoing manual therapy treatment. Eur J Pain. 2016;31 MAR 2016,:n/a-n/a.
21.
Fischer D, Stewart A, Bloch D, Lorig K, Laurent D, Holman H. Capturing the patient's view of change as a clinical outcome measure. JAMA. 1999;282(12):1157–62.CrossRef
22.
Kamper SJ, Ostelo RWJG, Knol DL, Maher CG, de Vet HCW, Hancock MJ. Global perceived effect scales provided reliable assessments of health transition in people with musculoskeletal disorders, but ratings are strongly influenced by current status. J Clin Epidemiol. 2010;63(7):760–6 e1.CrossRef
23.
O’Halloran B, Wright A, Cook CE. Original research. Criterion validation of the rate of recovery, a single alphanumeric measure, in patients with shoulder pain. Int J Sports Phys Ther. 2013;8(6):784–92.PubMedPubMedCentral
24.
Walker BF, Hebert JJ, Stomski NJ, Clarke BR, Bowden RSM, Losco B, French SD. Outcomes of usual chiropractic. The OUCH randomized controlled trial of adverse events. Spine. 2013;38(20):1723–9.CrossRef
25.
Adams M, Bogduk N, Burton K, Dolan P. The biomechanics of Back pain; 2006.
Metadata
Title
Do adverse events after manual therapy for back and/or neck pain have an impact on the chance to recover? A cohort study
Authors
Vesa Tabell
Ina M. Tarkka
Lena W. Holm
Eva Skillgate
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Chiropractic & Manual Therapies / Issue 1/2019
Electronic ISSN: 2045-709X
DOI
https://doi.org/10.1186/s12998-019-0248-9

Other articles of this Issue 1/2019

Chiropractic & Manual Therapies 1/2019 Go to the issue

Correction

Correction to: Knowledge of psychosocial factors associated with low back pain amongst health science students: a scoping review

Study protocol

Effectiveness of chiropractic manipulation versus sham manipulation on recurrent headaches in children aged 7–14 years, Protocol for a randomized clinical trial

Research

A perspective on Chiropractic Councils on Education accreditation standards and processes from the inside: a narrative description of expert opinion, part 1: Themes

Research

Psychosocial and behavioural characteristics in women with pregnancy-related lumbopelvic pain 12 years postpartum

Research

Managing sickness absence of patients with musculoskeletal pain – a cross-sectional survey of Scandinavian chiropractors

Research

Effect of active TENS versus de-tuned TENS on walking capacity in patients with lumbar spinal stenosis: a randomized controlled trial