Chiropractic Management of Knee Pain: A Retrospective Case-Series of Patient Outcomes at a Private Practice

Abstract

Background: Knee pain is a prevalent and debilitating condition affecting individuals of all ages, often limiting daily activities and diminishing quality of life. While many treatment options exist, there is continued interest in the effectiveness of conservative, non-pharmacological approaches. This article reviews outcomes for patients with knee pain undergoing chiropractic care. Methods: A retrospective case-series was conducted by reviewing the clinical files of 19 patients who presented with a chief complaint of knee pain at Sandstone Chiropractic - Huntsville. Data on initial and final self-reported pain scores, using an 11-point Numeric Pain Rating Scale (NPRS), were collected and analyzed. Percentage of pain reduction was calculated for each patient. Results: The cohort (n=19) demonstrated a mean pain reduction of 84% and a median pain reduction of 87%. Individual outcomes varied, but case vignettes illustrate significant improvements in patients with chronic pain, post-injury symptoms, and biomechanical issues. For instance, one patient reported a drop from 8/10 to 1/10 pain, while another with chronic activity-limiting pain achieved complete resolution (9/10 to 0/10). Conclusions: The findings suggest that a multi-modal chiropractic care plan may be an effective strategy for reducing pain in patients with various etiologies of knee pain. These promising results highlight the potential of this conservative approach, though further research with more rigorous designs is warranted.

Methods

This study was conducted as a retrospective case-series to evaluate the outcomes of patients receiving chiropractic care for knee pain at a single private practice, Sandstone Chiropractic - Huntsville. The inclusion criteria for the analysis required patients to have presented with a primary complaint of knee pain, completed a course of care, and had documented pre-treatment and post-treatment pain scores. A chart review identified a cohort of 19 patients meeting these criteria. Data were de-identified and extracted directly from clinical records. The primary outcome measure was the change in self-reported pain intensity, as measured on an 11-point Numeric Pain Rating Scale (NPRS), where 0 represents 'no pain' and 10 represents the 'worst pain imaginable'. Initial pain scores were recorded at the outset of care, and final pain scores were recorded at the time of discharge or re-evaluation after a significant treatment interval. The percentage of pain reduction was then calculated for each patient. Information on patient age range, gender, general complaint, and treatment timeframe was also collected when available. The treatment protocols were not standardized but were tailored to each patient's specific diagnosis and clinical presentation by the treating providers, Dr. Tony DeRamus or Dr. Mandi Sachs. Interventions could include a combination of Spinal Decompression Therapy, Knee Decompression, Spot Cryotherapy, Cold Laser Therapy, and Physical Rehabilitation exercises. No control group was used in this study.

Discussion

The findings from this retrospective case-series suggest that a multi-modal chiropractic approach can be a viable and effective option for managing various types of knee pain. The observed mean pain reduction of 84% across a 19-patient cohort is a substantial clinical effect, indicating that most patients experienced profound relief from their symptoms. The high median pain reduction of 87% further suggests that these positive outcomes were not skewed by a few exceptional results but were broadly representative of the patient group.

The success of the interventions may be attributable to the comprehensive nature of the care plans. As suggested by the available treatment modalities at the clinic—such as Knee Decompression, Cold Laser, and Physical Rehabilitation—and supported by a patient's testimonial (Case 6), the approach extends beyond simply treating the site of pain. By addressing underlying biomechanical dysfunctions in adjacent areas like the hip and lumbar spine, practitioners can correct faulty movement patterns that place excessive strain on the knee joint. Modalities like knee decompression may help reduce intra-articular pressure, while cold laser therapy and cryotherapy likely contribute by modulating local inflammation and accelerating tissue healing. While these results are promising, it is important to contextualize them. They align with the general goal of conservative care, which is to reduce pain and improve function while avoiding more invasive procedures like surgery. The patient who felt they avoided surgery (Case 8) provides a powerful anecdote in this regard. This case-series provides preliminary evidence supporting this model of care for knee pain and indicates that patients with both acute and chronic presentations may benefit.

Limitations

This study has several inherent limitations that must be considered when interpreting the results. First, its retrospective case-series design is observational and lacks a control group, making it impossible to definitively attribute patient improvements to the treatment alone; factors such as the natural history of the condition, placebo effect, or concurrent interventions cannot be ruled out. Second, the data were collected from a single private practice, which may limit the generalizability of the findings to other clinical settings, practitioners, or patient populations. Third, the primary outcome measure was a subjective, self-reported pain score (NPRS). While widely used, this metric is not supplemented by objective functional data, such as goniometric measurements of mobility or standardized functional tests. Fourth, the study is subject to potential selection bias, as it only includes patients who completed a course of care. Patients who dropped out early, possibly due to a lack of improvement, were not captured in this analysis, which could inflate the reported success rate.