Chiropractic Care + Tai Chi for Chronic Neck Pain
(CONNECKTCARE Trial)
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Harvard University Faculty of Medicine
Disqualifiers: Chiropractic care, Yoga, Tai Chi, others
No Placebo Group
Trial Summary
What is the purpose of this trial?This feasibility project aims to evaluate the effectiveness of chiropractic care combined with Tai Chi (TC) training to reduce pain and disability in adults with chronic non-specific neck pain (CNNP).
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the treatment Chiropractic Care + Tai Chi for Chronic Neck Pain?
Research shows that Tai Chi can significantly reduce pain and improve quality of life for people with chronic neck pain, making it a suitable alternative to conventional exercises. Additionally, combining manual therapy with exercise has been found effective in treating chronic neck pain, suggesting that the combination of Chiropractic Care and Tai Chi could be beneficial.
12345Is chiropractic care and Tai Chi safe for treating chronic neck pain?
Chiropractic care, which includes spinal manipulation, is generally safe but can cause mild and temporary side effects in about half of the patients. Serious complications are very rare. Tai Chi is considered a safe practice with minimal risk of adverse effects.
678910How does the treatment of Chiropractic Care + Tai Chi for chronic neck pain differ from other treatments?
This treatment is unique because it combines chiropractic care, which involves spinal manipulation to relieve pain, with Tai Chi, a gentle exercise that improves posture and reduces stress. This combination may offer a holistic approach to managing chronic neck pain, potentially providing benefits in pain reduction, functional improvement, and quality of life without the use of medication.
23111213Eligibility Criteria
This trial is for adults with chronic non-specific neck pain that occurs at least 5 days a week for over 3 months, with moderate to severe intensity. Participants must not have had chiropractic care or practiced Tai Chi regularly in the past year and should be free from major illnesses, unstable medical conditions, recent spinal procedures, or involvement in litigation related to disability/accident claims.Inclusion Criteria
My neck pain has been 3 or more on a scale of 0 to 10 over the last week.
I have had neck pain almost every day for the last 3 months.
My neck pain affects my daily activities.
+2 more
Exclusion Criteria
I have a disability that prevents me from exercising.
I have seen a chiropractor within the last year.
I do not have any major illness or mental health condition that needs immediate treatment.
+10 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive chiropractic care and/or Tai Chi training along with enhanced usual care over 16 weeks
16 weeks
10 chiropractic sessions, regular Tai Chi group training
Follow-up
Participants are monitored for safety and effectiveness after treatment
8 weeks
Long-term follow-up
Participants are assessed for longer-term outcomes and retention
24 weeks
Participant Groups
The study is testing if combining chiropractic care with Tai Chi training can help reduce pain and disability in people suffering from chronic non-specific neck pain. It's a feasibility project where participants will receive either this combined treatment or enhanced usual care.
3Treatment groups
Experimental Treatment
Active Control
Group I: Chiropractic Care, Tai Chi, and EUCExperimental Treatment3 Interventions
Participants assigned to this arm will receive 10 sessions of chiropractic care over 16 weeks, administered by chiropractors at collaborating clinics in the Greater Boston area. Participants assigned to this arm will also be enrolled in a community-based TC program. Participants will also be given a neck-pain self-care book that explains common causes and management strategies for neck pain.
Group II: EUCActive Control1 Intervention
Individuals assigned to the EUC alone group will be asked to continue their usual medical care as prescribed by their physician for 16 weeks. In addition, they will be asked to not seek chiropractic care or TC during the study. Participants will also be given a neck-pain self-care book that explains common causes and management strategies for neck pain. We will also provide this arm of participants with increased attention in the form of biweekly calls from the study research assistants.
Group III: Chiropractic care and EUCActive Control2 Interventions
Participants assigned to the chiropractic care+EUC arm will receive 10 sessions of chiropractic care over 16 weeks administered by chiropractors at collaborating clinics in the Greater Boston area. Participants will also be given a neck-pain self-care book that explains common causes and management strategies for neck pain.
Chiropractic Care is already approved in United States, Canada, Australia, European Union for the following indications:
🇺🇸 Approved in United States as Chiropractic Care for:
- Musculoskeletal disorders
- Neck pain
- Back pain
- Headaches
🇨🇦 Approved in Canada as Chiropractic Care for:
- Musculoskeletal disorders
- Neck pain
- Back pain
- Headaches
🇦🇺 Approved in Australia as Chiropractic Care for:
- Musculoskeletal disorders
- Neck pain
- Back pain
- Headaches
🇪🇺 Approved in European Union as Chiropractic Care for:
- Musculoskeletal disorders
- Neck pain
- Back pain
- Headaches
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Osher Clinical Center at Brigham and Women's HospitalChestnut Hill, MA
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Who Is Running the Clinical Trial?
Harvard University Faculty of MedicineLead Sponsor
Brigham and Women's HospitalCollaborator
References
Effectiveness of traditional bone setting in chronic neck pain: randomized clinical trial. [2022]This study evaluates the effectiveness of traditional bone setting (TBS) in chronic neck pain (cNP) compared with conventional physiotherapy (PT) and massage (M).
The Effects of Tai Chi and Neck Exercises in the Treatment of Chronic Nonspecific Neck Pain: A Randomized Controlled Trial. [2019]This study aimed to test the efficacy of Tai Chi for treating chronic neck pain. Subjects with chronic nonspecific neck pain were randomly assigned to 12 weeks of group Tai Chi or conventional neck exercises with weekly sessions of 75 to 90 minutes, or a wait-list control. The primary outcome measure was pain intensity (visual analogue scale). Secondary outcomes included pain on movement, functional disability, quality of life, well-being and perceived stress, postural and interoceptive awareness, satisfaction, and safety. Altogether, 114 participants were included (91 women, 49.4 ± 11.7 years of age). After 12 weeks Tai Chi participants reported significantly less pain compared with the wait list group (average difference in mm on the visual analogue scale: -10.5; 95% confidence interval, -20.3 to -.9; P = .033). Group differences were also found for pain on movement, functional disability, and quality of life compared with the wait list group. No differences were found for Tai Chi compared with neck exercises. Patients' satisfaction with both exercise interventions was high, and only minor side effects were observed. Tai Chi was more effective than no treatment in improving pain in subjects with chronic nonspecific neck pain. Because Tai Chi is probably as effective as neck exercises it may be considered a suitable alternative to conventional exercises for those with a preference toward Tai Chi.
Efficacy of Combining Traditional Chinese Manual Therapy (Tuina) and Specific Therapeutic Neck Exercise in Young Adults with Non-Specific Chronic Neck Pain: Study Protocol for a Randomized Controlled Trial. [2023]Non-specific chronic neck pain (NSCNP) is an increasingly common musculoskeletal disease and an important issue in the global healthcare system. Some studies have shown that the combination of manual therapy and exercise is effective in treating NSCNP but still with several limitations. Traditional Chinese manual therapy (tuina) is a Chinese manual therapy that consists of soft tissue manipulation and spinal manipulation. This study aims to design a randomized controlled trial to assess the effect of a tuina combined with specific therapeutic neck exercise modified protocol for NSCNP patients.
Physical Therapy Treatment Of Chronic Neck Pain A Discussion And Case Study: Using Dry Needling And Battlefield Acupuncture. [2016]Chronic mechanical neck pain can have a complex clinical presentation and is often difficult to treat. This case study illustrates a successful physical therapy treatment approach using dry needling and auricular acupuncture techniques.
A critical analysis of randomised clinical trials on neck pain and treatment efficacy. A review of the literature. [2019]The efficacy of physiotherapy or chiropractic treatment for patients with neck pain was analysed by reviewing 27 randomised clinical trials published 196-1995. Three different methods were employed: systematic analyses of; methodological quality; comparison of effect size; analysis of inclusion criteria, intervention and outcome according to The Disablement Process model. The quality of most of the studies was low; only one-third scored 50 or more of a possible 100 points. Positive outcomes were noted for 18 of the investigations, and the methodological quality was high in studies using electromagnetic therapy, manipulation, or active physiotherapy. High methodological quality was also noted in studies with traction and acupuncture, however, the interventions had either no effect or a negative effect on outcome. Pooling data and calculation of effect size showed that treatments used in the studies were effective for pain, range of motion, and activities of daily living. Inclusion criteria, intervention, and outcome were based on impairment in most of the analysed investigations. Broader outcome assessments probably would have revealed relationships between treatment effect and impairment, functional limitation and disability.
Prospective investigations into the safety of spinal manipulation. [2019]Spinal manipulation (SM) is a popular form of treatment of back and neck pain, as well as of other conditions. Uncertainty exists as to its safety. The aim of this systematic review was to summarize the data of all prospective investigations into the safety of SM. Five independent literature searches were carried out to identify all such studies. Data were extracted and validated according to pre-defined criteria. Five investigations met the inclusion criteria. The most valid studies suggest that about half of all patients will experience adverse events after chiropractic SM. These events are usually mild and transient. No reliable data exist about the incidence of serious adverse events. These data indicate that mild and transient adverse events seem to be frequent. Serious adverse events are probably rare but their incidence can only be estimated at present. Further prospective investigations are needed to define their incidence more closely.
Adverse events following chiropractic care for subjects with neck or low-back pain: do the benefits outweigh the risks? [2022]This synopsis provides an overview of the benign and serious risks associated with chiropractic care for subjects with neck or low-back pain. Most adverse events associated with spinal manipulation are benign and self-limiting. The incidence of severe complications following chiropractic care and manipulation is extremely low. The best evidence suggests that chiropractic care is a useful therapy for subjects with neck or low-back pain for which the risks of serious adverse events should be considered negligible.
Adverse events associated with the use of cervical manipulation and mobilization for the treatment of neck pain in adults: a systematic review. [2022]Adverse events (AE) are a concern for practitioners utilizing cervical manipulation or mobilization. While efficacious, these techniques are associated with rare but serious adverse events. Five bibliographic databases (PubMed, CINAHL, PEDro, AMED, EMBASE) and the gray literature were searched from 1998 to 2009 for any AE associated with cervical manipulation or mobilization for neck pain. Randomized controlled trials (RCTs), prospective or cross-sectional observational studies were included. Two independent reviewers conducted study selection, method quality assessment and data abstraction. Pooled relative risks (RR) were calculated. Study quality was assessed using the Cochrane system, a modified Critical Appraisal Skills Program form and the McHarm scale to assess the reporting of harms. Seventeen of 76 identified citations resulted in no major AE. Two pooled estimates for minor AE found transient neurological symptoms [RR 1.96 (95% CI: 1.09-3.54) p .05]. Forty-four studies (58%) were excluded for not reporting AE. No definitive conclusions can be made due to a small number of studies, weak association, moderate study quality, and notable ascertainment bias. Improved reporting of AE in manual therapy trials as recommended by the CONSORT statement extension on harms reporting is warranted.
Adverse events associated with the use of cervical spine manipulation or mobilization and patient characteristics: A systematic review. [2022]Cervical spinal manipulation (CSM) and cervical mobilization are frequently used in patients with neck pain and headache. Pre-manipulative cervical instability and arterial integrity tests appear to be unreliable in identifying patients at risk for adverse events. It would be valuable if patients at risk could be identified by specific characteristics during the preliminary screening. Objective was to identify characteristics of 1) patients, 2) practitioners, 3) treatment process and 4) adverse events (AE) occurring after CSM or cervical mobilization. A systematic search was performed in PubMed, Embase, CINAHL, Web-of-science, AMED, and ICL (Index Chiropractic Literature) up to December 2014. Of the initial 1043 studies, 144 studies were included, containing 227 cases. 117 cases described male patients with a mean age of 45 (SD 12) and a mean age of 39 (SD 11) for females. Most patients were treated by chiropractors (66%). Manipulation was reported in 95% of the cases, and neck pain was the most frequent indication. Cervical arterial dissection (CAD) was reported in 57% (P = 0.21) of the cases and 45.8% had immediate onset symptoms. The overall distribution of gender for CAD is 55% (n = 71) for female and therefore opposite of the total AE. Patient characteristics were described poorly. No clear patient profile, related to the risk of AE after CSM, could be extracted. However, women seem more at risk for CAD. There seems to be under-reporting of cases. Further research should focus on a more uniform and complete registration of AE using standardized terminology.
The benefits outweigh the risks for patients undergoing chiropractic care for neck pain: a prospective, multicenter, cohort study. [2007]This study describes both positive clinical outcomes and adverse events in patients treated for neck pain by a chiropractor.
Characteristics of Chiropractic Patients Being Treated for Chronic Low Back and Neck Pain. [2020]Chronic low back pain (CLBP) and chronic neck pain (CNP) are the most common types of chronic pain, and chiropractic spinal manipulation is a common nonpharmacologic treatment. This study presents the characteristics of a large United States sample of chiropractic patients with CLBP and CNP.
Chiropractic clinical practice guideline: evidence-based treatment of adult neck pain not due to whiplash. [2022]To provide an evidence-based clinical practice guideline for the chiropractic cervical treatment of adults with acute or chronic neck pain not due to whiplash. This is a considerable health concern considered to be a priority by stakeholders, and about which the scientific information was poorly organized.
Traditional Chinese Mind and Body Exercises for Neck Pain: A Meta-Analysis of Randomized Controlled Trials. [2023]Neck pain is common and can have a significant impact on patients' physical functionality, mobility, and quality of life (QOL). In clinical practice, traditional Chinese mind and body exercise (TCMBE) is a combination of different types of exercise based on traditional Chinese medicine, including qigong, tai chi, the 12-words-for-life-nurturing exercise, and so on, and many studies have found that it is safe and effective at helping patients with neck pain.