Chiropractic Management of Lower Back Pain: A Retrospective Case-Series of 105 Patients at a Single Clinic

Abstract

Background: Lower back pain (LBP) is a widespread condition causing significant pain and disability. Chiropractic care is a common non-pharmacological treatment option, but more practice-based evidence is needed to document outcomes. This study summarizes the results of chiropractic care for a cohort of patients with LBP. Methods: A retrospective case-series was conducted on data from Spine Stop Chiropractic Franklin. The study included 105 de-identified patients who presented with LBP and completed a course of care. The primary outcome measure was the change in self-reported pain, measured on a numeric rating scale (NRS) from baseline to the conclusion of the treatment plan. Results: The cohort of 105 patients experienced a mean pain reduction of 88% and a median pain reduction of 88%. Individual cases demonstrated improvements across various presentations, including acute, chronic, and post-injury LBP. For instance, a patient aged 55-64 with persistent lumbar pain reported a 100% reduction in pain over 12 weeks, while a patient aged 30-39 with an acute lifting injury achieved an 85% pain reduction in 4 weeks. Conclusion: In this retrospective case-series, patients undergoing chiropractic care for lower back pain reported substantial improvements in pain levels. These findings support the potential role of chiropractic management for LBP, though further controlled research is required to establish causality.

Methods

This study employed a retrospective case-series design to evaluate the outcomes of patients receiving chiropractic care for lower back pain at Spine Stop Chiropractic Franklin in Franklin, KY. Data was collected from the de-identified records of 105 patients who presented with a primary complaint of lower back pain and completed their prescribed treatment plan at the clinic under the care of Dr. Grant Watkins, D.C.

Inclusion criteria for this analysis required patients to have a recorded chief complaint related to lower back pain (e.g., ICD-10 M54.5) and to have pre-treatment and post-treatment pain scores documented in their files. The primary outcome measure was self-reported pain, assessed using a Numeric Rating Scale (NRS) where 0 indicates 'no pain' and 10 indicates the 'worst possible pain'. Data on initial and final pain scores were extracted to calculate the percentage of pain reduction for each individual and the mean and median reduction for the entire cohort. Other data points such as patient age range, complaint details, and treatment duration were also collected when available.

Data analysis was primarily descriptive. An aggregate pain reduction percentage was calculated for the cohort (n=105). Individual case data were reviewed to provide illustrative examples of patient presentations and outcomes. No control group was used for comparison. The study relied on existing clinical records, and all patient information was de-identified prior to analysis to protect patient privacy. The techniques used during care were not standardized for this review but represented the clinical judgment of the provider.

Discussion

The findings of this retrospective case-series suggest that chiropractic care was associated with positive outcomes for a cohort of 105 patients with lower back pain at a single private practice. The reported mean pain reduction of 88% is a clinically significant result, indicating that the vast majority of patients who completed their care plans experienced substantial relief from their symptoms. The consistency between the mean and median values suggests that these positive results were widespread throughout the cohort and not skewed by a few exceptional outcomes.

The individual case vignettes highlight the applicability of care across a spectrum of patient presentations. Relief was reported by patients with acute injury-related pain (Case 5), chronic discogenic pain (Case 10), and persistent lumbar pain that had become a long-standing issue (Case 6). The timeframes for improvement varied from 4 to 12 weeks, which aligns with typical expectations for conservative care plans for such conditions. The ability to return to daily activities, as mentioned in Case 4, underscores the functional significance of pain reduction.

These results are consistent with broader clinical literature that supports the use of chiropractic manipulation and manual therapies for the management of non-specific lower back pain. While the specific techniques employed by the provider were not detailed in this study, the outcomes demonstrate the potential benefits of a chiropractic approach in a real-world setting. However, it is crucial to interpret these findings within the context of the study's design. Without a control group, it is impossible to definitively attribute the observed improvements solely to the chiropractic intervention. Factors such as the natural history of LBP, placebo effects, and regression to the mean cannot be ruled out. Nonetheless, the data provides valuable practice-based evidence of positive patient-reported outcomes.

Limitations

This study has several important limitations inherent to its design. As a retrospective case-series, it is susceptible to information bias and may be affected by incomplete or inconsistently recorded data. The primary limitation is the absence of a control group, which prevents the establishment of a cause-and-effect relationship between the chiropractic intervention and patient outcomes. The observed improvements could be influenced by the natural history of the condition, placebo effects, or regression to the mean.

Furthermore, the study was conducted at a single clinic with one provider, which limits the generalizability of the findings to other chiropractic practices or patient populations. The analysis included only patients who completed their care plans, introducing a potential selection bias; individuals who discontinued care, possibly due to a lack of improvement, were not included. Finally, the primary outcome measure relied on self-reported pain scores, which are subjective by nature. Objective functional measures were not systematically assessed.