Chiropractic Management of Knee Pain: A Retrospective Case-Series of 18 Patients in a Private Practice

Abstract

Background: Knee pain is a prevalent musculoskeletal complaint that significantly impacts quality of life. Conservative management, including chiropractic care, often focuses on addressing underlying biomechanical dysfunctions. This report summarizes patient outcomes following chiropractic care for knee pain. Methods: A retrospective case-series was conducted by reviewing de-identified patient records from TexStar Chiropractic in Austin, TX. The study included 18 patients who presented with knee pain, completed a course of care, and had documented pre- and post-treatment pain scores. The primary outcome measure was the percentage change in patient-reported pain on a 10-point numeric rating scale (NRS). Results: The cohort of 18 patients reported a mean pain reduction of 89% and a median pain reduction of 92%. Initial average pain scores were reduced significantly following the treatment period. Individual cases demonstrated improvements in pain associated with activities like stair climbing, running, and squatting, with some patients reporting avoidance of anticipated knee surgery. Conclusions: Within this case-series, patients receiving chiropractic care for knee pain reported substantial improvements in pain levels. These findings suggest that this conservative approach may be a valuable option for certain patients, warranting further investigation through more rigorous controlled trials.

Methods

This study was conducted as a retrospective case-series to evaluate the outcomes of patients treated for knee pain at a private chiropractic clinic. Data were sourced from a de-identified cohort of 18 patient files from TexStar Chiropractic in Austin, TX. The practitioners involved in patient care were Michael P. Henry, DC, and Amy M. Ho, DC.

Inclusion criteria for this series required that patients presented with a primary complaint of knee pain, underwent a course of chiropractic treatment at the clinic, and had documented baseline and post-treatment pain scores. The primary outcome measure was the change in self-reported pain intensity, captured using a 10-point Numeric Rating Scale (NRS), where 0 represents 'no pain' and 10 represents 'the worst pain imaginable'. The percentage of pain reduction was calculated for each case where initial and final pain scores were available. Mean and median pain reduction were then calculated for the entire cohort (n=18).

Data was collected through a review of existing clinical records. No new data was generated for the purpose of this study. Information regarding specific treatment protocols, techniques used, and diagnostic codes (ICD-10) was not available in the aggregated data set. Due to the retrospective and observational nature of the design, this study does not include a control or comparison group. The findings are therefore descriptive and cannot be used to infer causation. All data presented are based on verified outcomes documented by the clinic.

Discussion

The findings from this retrospective case-series suggest that chiropractic care may be an effective management strategy for certain patients experiencing knee pain. The aggregate result of an 89% mean reduction in self-reported pain is a clinically significant outcome for this cohort of 18 patients. This level of improvement suggests that the interventions provided at this clinic had a substantial positive impact on the patients' primary complaint.

Several patient narratives highlight a key tenet of a biomechanical approach to knee pain: addressing extraspinal and extra-articular sources of dysfunction. For instance, multiple patients (Case 3, Case 9, Case 12) specifically mentioned that treatment focused on 'hip mechanics' was instrumental in their recovery. This aligns with clinical understanding of the kinetic chain, where malalignment or improper muscle function at the hip and pelvis can lead to aberrant forces at the knee, resulting in pain. The successful outcomes in cases described as 'patellar tracking issues' (Case 6, Case 7, Case 10, Case 12) further support the idea that restoring proper biomechanics can alleviate symptoms.

A notable clinical implication from these cases is the potential for conservative care to serve as a viable alternative to more invasive procedures. Several patients (Case 4, Case 6, Case 8, Case 11) reported they were 'bracing for knee surgery' and that the treatment they received 'changed the trajectory entirely.' While this is anecdotal, it points to the value of exhausting conservative options before considering surgical intervention, potentially reducing healthcare costs and patient risks associated with surgery. The results, while promising, must be interpreted with caution due to the study's inherent limitations.

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 determine if the observed improvements were a direct result of the chiropractic intervention, the natural history of the condition, a placebo effect, or other confounding variables. The data were collected from existing clinical records and were not gathered for research purposes, which may lead to inconsistencies in documentation.

The findings are from a single clinic (TexStar Chiropractic - Austin) and may not be generalizable to other patient populations, clinical settings, or practitioners. Furthermore, outcome measures were based on self-reported pain scores (NRS), which are subjective and can be influenced by patient expectations and recall bias. The potential for selection bias is also present, as case series may inadvertently feature patients who experienced favorable outcomes. Specific treatment modalities and frequencies were not analyzed, precluding any conclusions about which components of care were most effective.