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

Abstract

Background: Knee pain is a prevalent musculoskeletal complaint that significantly impacts quality of life. Conservative care, including chiropractic management, is a common non-invasive treatment approach. This article reports on outcomes for a cohort of patients with knee pain. Methods: A retrospective case-series was conducted by reviewing de-identified patient records from TexStar Chiropractic in Buda, TX. The study included 19 adult patients presenting with a chief complaint of knee pain who had completed a course of care. The primary outcome measure was patient-reported pain intensity on a numeric rating scale (NRS) before and after treatment. Results: The analysis of 19 cases showed a mean pain reduction of 84% and a median pain reduction of 86%. Patient narratives indicated functional improvements, such as returning to running and improved stair climbing ability. Several patients reported avoiding previously considered surgical interventions. Conclusions: The findings from this retrospective case-series suggest that the chiropractic protocols utilized at this clinic may be effective for reducing pain and improving function in patients with various types of knee pain. The results are promising; however, due to the study's limitations, including the lack of a control group, further research through prospective, controlled trials is warranted to substantiate these observations.

Methods

This study employed a retrospective case-series design to evaluate the outcomes of patients treated for knee pain at a single chiropractic center, TexStar Chiropractic in Buda, TX. Data were drawn from a convenience sample of 19 de-identified patient files. Inclusion criteria for this review required that patients presented with a primary complaint of knee pain, had undergone a course of chiropractic care at the clinic, and had documented pre- and post-treatment pain scores. Data were extracted from existing patient records by clinic staff. The primary outcome measure was patient-reported pain intensity, documented using a 0-to-10 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 with available data using the formula: [(Initial Pain Score – Final Pain Score) / Initial Pain Score] x 100. Aggregate data were analyzed for descriptive statistics, including the mean and median pain reduction for the cohort (n=19). Qualitative data, including patient-reported functional improvements and subjective experiences, were also extracted from case notes and testimonials to provide clinical context. This study did not involve direct patient contact and was conducted solely through the analysis of existing, de-identified records. The specific treatment protocols were not detailed but are understood to represent the clinical approach of the providers at the specified practice.

Discussion

The results of this retrospective case-series suggest that the chiropractic care delivered at TexStar Chiropractic - Buda is associated with substantial reductions in pain for patients with knee complaints. The mean pain reduction of 84% across a cohort of 19 patients is a clinically meaningful finding. These outcomes appear to be robust for patients of various ages and with different presumed etiologies of knee pain, from chronic degenerative issues to overuse and post-traumatic complaints.

The qualitative data, although subjective, provide valuable insight into the functional impact of the observed pain reduction. Patient reports of returning to running, improved ability to negotiate stairs, and regaining the ability to play with children suggest that the benefits extend beyond simple pain modulation to tangible improvements in quality of life. Furthermore, multiple patient narratives allude to avoiding surgery, highlighting the potential role of this conservative approach in helping patients avert more invasive and costly interventions.

One patient's comment that the providers "fixed the hip mechanics" suggests that the clinical protocol may incorporate a holistic, biomechanical approach that addresses contributing factors outside the local knee area. This aligns with contemporary models of musculoskeletal care that emphasize the importance of the entire kinetic chain in lower extremity function. The high level of patient-reported success may be attributable to this comprehensive strategy. While these results are encouraging, they must be interpreted within the context of the study's design. Without a control group, it is not possible to determine the extent to which the observed improvements are a direct result of the treatment versus other factors such as placebo effect, the natural history of the conditions, or concurrent self-care activities.

Limitations

This study has several important limitations. As a retrospective case-series, it lacks a control group, making it impossible to definitively attribute the observed pain reduction to the chiropractic intervention alone. Factors such as the natural history of knee pain, regression to the mean, and the placebo effect cannot be ruled out. The data were collected from a single clinic, which limits the generalizability of the findings to other patient populations or clinical settings. The reliance on patient self-reported pain scores (NRS) introduces subjectivity, and the study did not employ standardized, validated functional outcome measures. Furthermore, the use of a convenience sample of files with complete data may introduce selection bias, as cases with less favorable outcomes or incomplete documentation may have been excluded, potentially overstating the apparent treatment effectiveness. The specific treatment protocols were not standardized or detailed in this review, preventing replication or specific technique analysis.