Chiropractic Management of Knee Pain: A Retrospective Case Series of Outcomes from a Private Practice

Abstract

Background: Knee pain is a prevalent musculoskeletal condition that impairs function and quality of life. Conservative management is often the first line of treatment. This article summarizes outcomes for a cohort of patients with knee pain undergoing chiropractic care. Methods: A retrospective case series was conducted on 18 patients treated for knee pain at TexStar Chiropractic - Bee Cave. Data were extracted from patient records, including self-reported pain on a 10-point numerical rating scale at the beginning and end of the treatment period. Pain reduction percentages were calculated for each case. Results: The 18 patients in this series reported a mean pain reduction of 83% (median: 83%). Individual cases demonstrated significant improvements, such as a 55-64 year-old female who avoided potential surgery after her pain resolved from 7/10 to 0/10, and a 25-34 year-old male whose bilateral knee pain improved from 9/10 to 1/10 after care that addressed hip mechanics. Treatment timeframes varied, with significant gains often noted within 6 to 12 weeks. Conclusions: The findings from this case series suggest that the chiropractic care protocols employed at this clinic may be an effective treatment option for reducing pain and improving function in patients with various types of knee pain. Further controlled research is warranted to validate these observations.

Methods

This study was conducted as a retrospective case series to evaluate outcomes for patients with a chief complaint of knee pain. All data were collected from existing patient records at a single private practice, TexStar Chiropractic - Bee Cave, located in Bee Cave, TX. The practitioners providing care during the treatment periods included Dr. Michael P. Henry, Dr. John E. Jacobson, and Dr. Chad M. Patrick. The inclusion criteria for this series required patients to have presented with knee pain as a primary or significant complaint and to have completed a course of care with documented pre- and post-treatment pain scores. A total of 18 patient cases met these criteria. Data extracted for analysis included patient age range, gender, chief complaint, and self-reported pain levels. Pain was measured using a 10-point numerical rating scale (NRS), where 0 represented 'no pain' and 10 represented 'the worst pain imaginable'. The 'initial pain' score was recorded at the initial consultation, and the 'final pain' score was recorded at the conclusion of the patient's active care plan. The primary outcome measure was the percentage of pain reduction, calculated for each individual. Aggregate statistics, including the mean and median pain reduction, were calculated for the entire cohort (n=18). No objective measures of mobility improvement were systematically tracked in the patient records, so this metric was not included in the analysis. The retrospective nature of this review is a primary limitation.

Discussion

The results of this retrospective case series suggest that the chiropractic protocols utilized at TexStar Chiropractic - Bee Cave are associated with substantial pain reduction for patients with knee pain. The observed mean pain reduction of 83% across a cohort of 18 patients is a clinically significant finding. These outcomes are particularly noteworthy given the diversity of the patient population in terms of age and presenting complaints, from patellar tracking issues to chronic pain limiting athletic activity.

A recurring theme in the qualitative patient reports was the focus on biomechanics beyond the knee joint itself, with several patients noting that treatment addressed their hips and pelvis. This aligns with a contemporary understanding of the lower kinetic chain, where dysfunction in proximal joints can manifest as pain and stress distally at the knee. The cases of individuals who were able to avoid potential surgery (Case 3) or return to high-impact activities like running (Case 5) highlight the potential functional impact of this conservative care approach. These positive outcomes can represent a significant shift in a patient's quality of life and healthcare trajectory.

While promising, these findings must be interpreted with caution. The study's design as a retrospective case series without a control group means it is not possible to definitively attribute the entirety of the observed improvement to the chiropractic intervention. Factors such as the natural history of the condition, placebo effect, and regression to the mean cannot be ruled out. Nonetheless, the consistency of positive outcomes across this cohort indicates that the multimodal approach employed warrants further, more rigorous investigation through prospective controlled trials to establish efficacy and generalizability.

Limitations

This study has several important limitations inherent to its design. As a retrospective case series, the data were not collected for a research purpose, which can lead to inconsistencies in documentation. The findings are from a single chiropractic clinic, and therefore may not be generalizable to other practices, practitioners, or patient populations. The most significant limitation is the absence of a control group, which makes it impossible to determine causality or to separate the effects of the treatment from the placebo effect, the natural course of the condition, or other unmeasured factors. All outcome measures were based on patient self-report (pain NRS), which is subjective and was not accompanied by objective functional metrics like range of motion or strength testing. Finally, there is a risk of selection bias, as patients who complete a full course of care and have their outcomes documented may be those who experienced better results, potentially inflating the overall success rate.