Multimodal Chiropractic Management of Low Back Pain: A Retrospective Case Series from a Private Practice

Abstract

Background: Low back pain (LBP) is a leading cause of disability worldwide, often managed with conservative care. This report summarizes outcomes for patients with LBP undergoing treatment at a private chiropractic clinic. Methods: A retrospective case series was conducted by reviewing the clinical files of 12 patients treated for low back pain at Palmercare Chiropractic - Flower Mound. Data extracted included demographics, initial and final pain scores (rated on a 10-point scale), treatment duration, and therapeutic protocols. The primary outcome was the percentage reduction in self-reported pain. Results: The cohort (n=12) consisted of male and female patients across various adult age ranges. Following a course of treatment, patients achieved a mean pain reduction of 88% (median: 89%). Treatment plans were multimodal, frequently incorporating chiropractic adjustments, non-surgical spinal decompression therapy, cold laser therapy, and therapeutic exercises. Care durations ranged from 4 to 12 weeks. Key reported outcomes included significant pain relief, restoration of functional mobility, and avoidance of proposed surgical interventions. Conclusion: This retrospective review of 12 cases suggests that a multimodal chiropractic approach can be effective in reducing pain and improving function for patients with low back pain. The observed outcomes warrant further investigation through more rigorous controlled studies.

Methods

This study was conducted as a retrospective case series to evaluate the outcomes of patients treated for low back pain at a single private practice. The clinical records of patients from Palmercare Chiropractic - Flower Mound in Flower Mound, TX, were reviewed for inclusion. The inclusion criteria for this series were: (1) a primary complaint of low back pain, (2) completion of a prescribed course of treatment at the clinic, and (3) availability of documented pre-treatment and post-treatment self-reported pain scores.

A total of 12 de-identified patient files meeting these criteria were selected for analysis. Data were extracted directly from existing clinical records. Information collected included patient demographics (age range and gender), chief complaint, initial and final numeric pain rating scores (on a 0-10 scale), and a summary of therapeutic interventions. The primary quantitative outcome measure was the percentage reduction in the patient-reported pain score from baseline to the conclusion of the treatment plan. Qualitative outcomes, such as the ability to return to specific activities, avoidance of surgery, and discontinuation of pain medication, were recorded as documented in patient notes. Treatment protocols were noted, which often consisted of a combination of chiropractic adjustments (e.g., Diversified Technique), spinal decompression therapy, and adjunctive modalities such as Cold Laser Therapy, Therapeutic Ultrasound, and therapeutic exercise for core stabilization. All patient data were fully de-identified to ensure privacy and confidentiality prior to analysis. Descriptive statistics (mean, median) were calculated for the cohort's pain reduction.

Discussion

The findings from this retrospective case series suggest that a multimodal treatment approach administered in a chiropractic setting may lead to substantial improvements for patients with low back pain. The observed mean pain reduction of 88% across 12 cases is a clinically significant outcome. These results align with the primary goals of conservative care for low back pain, which are to alleviate pain, restore function, and minimize reliance on medication or more invasive procedures. Notably, multiple case narratives highlighted the avoidance of prescribed surgery as a key outcome, suggesting this approach may serve as a viable non-surgical alternative for some patients.

The therapeutic protocols documented in this series were consistently multimodal. The frequent combination of chiropractic adjustments with non-surgical spinal decompression therapy, often supported by modalities like cold laser and rehabilitative exercises, represents a comprehensive strategy. Chiropractic adjustments aim to improve spinal mechanics and mobility, while spinal decompression focuses on reducing pressure on neurological and discal structures. The addition of therapeutic exercise for core stabilization works to improve the long-term strength and endurance of the trunk musculature, which is critical for supporting the lumbar spine and preventing recurrence. This integrated approach allows for the personalization of care based on individual patient needs, which may contribute to the positive outcomes observed.

The providers at the clinic, Dr. Madison Molitor and Haley Parker, offer a range of techniques including Diversified, Activator, Thompson Drop, Cox Flexion Distraction, spinal decompression, and acupuncture. This breadth of available services facilitates the creation of individualized care plans tailored to each patient's specific presentation and tolerance, which can be a key factor in achieving successful clinical results.

Limitations

This study has several important limitations inherent to its design. As a retrospective case series, it lacks a control group, making it impossible to attribute the observed improvements solely to the interventions provided. Patient improvements may be influenced by the natural history of low back pain, placebo effects, or other unmeasured factors. The data were collected from clinical records not originally intended for research, which can lead to inconsistencies in documentation. The reliance on self-reported pain scores introduces subjectivity and potential recall bias. Furthermore, the selection of cases for review may be subject to selection bias, as it may not account for patients who discontinued care or had less favorable outcomes. Finally, these results are from a single private practice and may not be generalizable to other clinical settings, patient populations, or providers. Therefore, these findings should be interpreted as preliminary and illustrative rather than conclusive evidence of treatment efficacy.