Multimodal Chiropractic Management of Cervicalgia: A Retrospective Case Series from a Private Practice

Abstract

Background: Cervicalgia, or neck pain, is a prevalent musculoskeletal condition causing significant pain and disability. This study's purpose is to report outcomes for patients with cervicalgia undergoing multimodal chiropractic care at a private clinic. Methods: A retrospective case series was conducted on 27 de-identified patient files from Indian Trail Chiropractic & Rehab. All patients presented with a primary diagnosis of cervicalgia (M54.2), completed a full course of care, and had documented pre- and post-treatment outcome measures. Interventions were patient-specific and included chiropractic adjustments, soft tissue therapies (Active Release Technique, Graston Technique), therapeutic modalities (laser, shockwave, e-stim), and corrective exercises. Results: The cohort (n=27) demonstrated a mean self-reported pain reduction of 93% (median 92%) and a mean mobility improvement of 91% (median 90%). Individual cases showed marked improvements in pain scales (NPRS), disability indices (NDI), and objective range of motion measurements. Conclusion: In this retrospective case series, a chiropractor-led multimodal treatment approach was associated with significant improvements in pain, disability, and function for patients with acute and chronic cervicalgia. These findings suggest this conservative care model warrants further investigation.

Methods

This study was conducted as a retrospective review of patient case files from a single chiropractic clinic, Indian Trail Chiropractic & Rehab in Indian Trail, NC. A cohort of 27 patient cases was selected for inclusion based on a set of predefined criteria. To be included, patients must have presented with a chief complaint of neck pain, received a clinical diagnosis of cervicalgia (ICD-10: M54.2), and completed a full plan of care as prescribed by the treating provider, Dr. Cameron Gentile, DC. Furthermore, each included file was required to contain documented initial and final outcome assessments, allowing for a quantitative analysis of progress.

Data was de-identified prior to analysis to protect patient privacy. Information extracted from each file included patient age range, gender, duration and nature of the chief complaint, and the specific treatment protocols administered. The primary outcome measures varied by case but included the Numeric Pain Rating Scale (NPRS), the Neck Disability Index (NDI), and goniometric measurements of cervical range of motion. Pain reduction and mobility improvement percentages were calculated based on these initial and final metrics.

The interventions provided were multimodal and tailored to each patient's specific clinical presentation. The therapeutic arsenal available at the clinic and utilized in this cohort included chiropractic adjustments of the spine and extremities, soft tissue therapies such as Active Release Technique (ART) and Graston Technique, spinal decompression, therapeutic exercise prescription, and modalities including Erchonia low-level laser therapy, shockwave therapy, and electrical muscle stimulation. This report summarizes the aggregate results and presents individual vignettes to illustrate the clinical course.

Discussion

The findings of this retrospective case series suggest that a multimodal chiropractic treatment protocol, as delivered at Indian Trail Chiropractic & Rehab, was associated with positive outcomes for a cohort of 27 patients with cervicalgia. The reported aggregate improvements—a 93% mean pain reduction and 91% mean mobility improvement—are clinically significant and represent a near-complete resolution of symptoms for many patients in this group.

The strength of the therapeutic approach described here likely lies in its integration of multiple evidence-informed interventions. Chiropractic adjustments address joint restrictions, which are a common component of neck pain. Soft tissue therapies like Active Release Technique and Graston Technique target myofascial adhesions and muscle hypertonicity that contribute to pain and limit movement. Therapeutic modalities such as shockwave and low-level laser therapy may further aid in pain modulation and facilitate tissue healing processes. Finally, the inclusion of corrective exercises provides patients with a tool for self-management, helping to reinforce clinical gains and potentially reduce the risk of recurrence.

The consistency of positive outcomes across varied patient presentations—from acute, traumatic onset to chronic, insidious pain, and across a wide age range—is noteworthy. Cases involving high levels of initial disability (e.g., NDI 41%) showed dramatic functional improvement, while those with significant mobility restrictions demonstrated substantial gains in range of motion. These results align with the clinical goal of not only alleviating pain but also restoring function. While these results are promising, the limitations of the study design necessitate a cautious interpretation. Future prospective, controlled studies are required to establish a causal relationship between this multimodal approach and patient outcomes in the management of cervicalgia.

Limitations

This study has several important limitations inherent to its retrospective case-series design. First, the absence of a control or comparison group means it is not possible to attribute the observed improvements solely to the interventions provided. The natural history of cervicalgia, placebo effects, and regression to the mean could have contributed to the outcomes. Second, the data was collected from a single clinical practice, which may limit the generalizability of the findings to other patient populations or clinical settings. The specific skill of the provider and the patient demographics of the area may be unique. Third, the reliance on some self-reported outcome measures, such as the NPRS and NDI, introduces a degree of subjectivity. Finally, there is a potential for selection bias, as the series includes only patients who completed their full course of care; individuals who dropped out, perhaps due to a lack of perceived progress, were not included in the analysis.