Case-series · July 29, 2026
Spinal Health Outcomes in a Chiropractic Setting: A Retrospective Case Series from Missoula, MT
Abstract
Background: Spinal health is crucial for overall well-being, with conditions like lower back and neck pain impacting quality of life for many individuals. Chiropractic care offers a non-pharmacological approach to address these concerns. Methods: This retrospective case series analyzed data from four female patients at Primal Practice in Missoula, MT, presenting with chief complaints of lower back pain or neck pain. Data collected included initial and final pain scores, and calculated pain reduction percentages over 13-15 weeks. Mobility improvement was not consistently tracked. Results: The mean pain reduction observed across the four cases was 3%, with a median of 2%. Individual cases showed pain reductions ranging from 1% to 8%. For instance, one patient with lower back pain reported an 8% reduction in pain over 13 weeks. Limitations include the small sample size, retrospective design, lack of a control group, and reliance on self-reported pain scores. Conclusions: The modest pain reduction observed in this small case series suggests a limited impact on initial pain scores within the studied timeframe and population. Further research with larger cohorts and standardized outcome measures is warranted to better understand the effectiveness of chiropractic interventions for spinal health improvement.
Methods
This study constitutes a retrospective case series analyzing de-identified patient data collected from Primal Practice, a chiropractic clinic located in Missoula, MT. Primal Practice provides a range of chiropractic services including Nervous System Scans, Preconception & Fertility Chiropractic, Pregnancy & Prenatal Chiropractic (Webster Technique), Postpartum Recovery Care, Gentle Pediatric Chiropractic, Family Wellness Adjustments, Nervous System Regulation Care, and Dynamic Body Balancing (Cranial Sacral + Myofascial). The patient records included in this review were from individuals who received care between 2023 and 2024 and had verified outcome metrics related to their spinal health. Inclusion criteria for this case series focused on adult female patients presenting with a chief complaint of either lower back pain or neck pain, for whom both initial and final pain scores were recorded. Data was extracted for four such cases. Metrics captured for each patient included age range, gender, chief complaint, initial pain score, final pain score, and the calculated pain reduction percentage. The timeframe of care for each patient was also recorded. Pain scores were self-reported measures, presumably utilizing a scale where a higher number indicates greater pain. Mobility improvement was not consistently tracked or reported in the available data and therefore could not be included in the aggregate analysis. No specific treatment protocols beyond standard chiropractic care at Primal Practice were detailed in the de-identified data. Ethical considerations associated with retrospective data analysis, such as patient anonymity, were maintained by utilizing de-identified records. Limitations of this methodological approach include its retrospective nature, the small sample size (n=4), the absence of a control group, and the reliance on self-reported, non-standardized pain metrics, which inherently introduces variability and potential for recall bias. Furthermore, as a single-site study, the generalizability of these findings is limited.
Discussion
The findings from this retrospective case series, though limited by its small sample size, offer an initial glimpse into spinal health outcomes at Primal Practice. The observed mean pain reduction of 3% and median of 2% suggests a modest impact on initial pain scores within this specific group of four female patients. This level of change, while positive for some individuals (e.g., Case 1 with an 8% reduction), may not represent substantial clinical improvement when compared to general expectations for musculoskeletal pain interventions, where larger percentage reductions are often desired to indicate clinical significance. However, it is important to contextualize these percentages. The baseline pain scores, for example, ranged from 68 to 84 (presumably on a 0-100 scale), indicating relatively high initial pain levels. Even small reductions in these scores could translate to some level of subjective improvement for the patient. The consistency of these relatively minor changes across most cases (three out of four cases showed a 1-3% reduction) suggests either a consistently limited effect in this sample or highlights the challenges in measuring subtle improvements with self-reported, non-standardized metrics. Given the clinic's focus on Nervous System Scans and Nervous System Regulation Care, it is possible that improvements in neurological function or overall well-being, which were not overtly captured by a 'pain reduction percentage' metric, may have occurred. Clinical implications drawn from this data are necessarily cautious. While chiropractic care is a common choice for spinal pain, these specific results do not strongly affirm significant pain reduction in this small cohort. Future studies should aim for more robust outcome measures, such as validated pain scales and functional status questionnaires, alongside larger patient cohorts, to better assess the effectiveness and broader clinical utility of the techniques employed at Primal Practice for spinal health conditions.
Limitations
This retrospective case series is subject to several significant limitations. The small sample size of only four cases severely restricts the generalizability and statistical power of the findings, rendering them indicative rather than definitive. As a single-site study conducted at Primal Practice, the results may not be representative of outcomes from other chiropractic clinics or broader chiropractic practice. The retrospective design inherently introduces reporting bias and limits the control over data collection methods; specifically, mobility improvement metrics were not consistently tracked. The reliance on self-reported pain scores, while common in clinical practice, lacks standardization and may be influenced by subjective factors, potentially affecting the accuracy and comparability of the data. Furthermore, the absence of a control group precludes attributing observed changes directly to the chiropractic interventions, as natural history or other unmeasured factors could contribute to pain fluctuations. Finally, potential selection bias may exist, as only cases with readily available and complete initial and final pain scores were included.