Chiropractic Management of Knee Pain: A Retrospective Case Series of 19 Patients

Abstract

Background: Knee pain is a prevalent musculoskeletal complaint that significantly impacts mobility and quality of life. Conservative management strategies are a primary focus of patient care. This article examines the outcomes of patients receiving chiropractic care for knee pain at a single clinic. Methods: A retrospective case series was conducted on 19 patients who sought care for knee pain at TexStar Chiropractic in Dripping Springs, TX. Data were extracted from de-identified patient files. The primary outcome measure was the change in self-reported pain intensity, measured on a 10-point numeric rating scale, from initial presentation to final assessment. Results: The cohort of 19 patients reported a mean pain reduction of 87% (median 87%). Initial pain scores ranged from 7/10 to 9/10, while final pain scores ranged from 0/10 to 2/10. Treatment durations varied, with some courses of care lasting up to 12 weeks or 20 visits. Patient narratives frequently mentioned improvements in functional activities like navigating stairs and running. Conclusions: In this case series, patients with knee pain reported substantial improvements in pain following a course of chiropractic care. These findings suggest that a chiropractic approach may be a viable conservative treatment option for certain individuals with knee pain, warranting further investigation through more rigorous controlled studies.

Methods

This study was conducted as a retrospective case series to evaluate patient-reported outcomes following chiropractic care for knee pain. Data were sourced from de-identified patient records at TexStar Chiropractic, a private practice located in Dripping Springs, TX, under the clinical leadership of Corey J. Miller, DC, and oversight of founder Michael P. Henry, DC.

The inclusion criteria for this series required patients to have presented with a chief complaint of knee pain, completed a course of in-clinic treatment, and have documented pre-treatment and post-treatment outcome measures. A total of 19 de-identified patient cases met these criteria. The patient population included adult males and females with ages ranging from the 25-34 bracket to 65+.

The primary outcome measure was 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.' Initial and final pain scores were extracted from clinical notes to calculate the percentage of pain reduction for each individual. Aggregate statistics, including the mean and median pain reduction for the cohort, were then calculated. Other data collected included patient age range, gender, chief complaint, and the timeframe of care. Treatment protocols were not standardized and were tailored to individual patient needs based on the providers' clinical judgment. Mobility improvements were anecdotally reported by patients but were not measured using a formal, quantifiable metric and thus are not reported as a quantitative outcome in this series. The inherent limitations of a retrospective design, such as the lack of a control group and potential for selection bias, are acknowledged.

Discussion

The findings from this retrospective case series suggest that chiropractic care was associated with substantial pain reduction for a cohort of 19 patients with knee pain. A mean pain reduction of 87% is a clinically meaningful improvement that, for many patients, represents a shift from debilitating pain to minimal or no discomfort. This level of improvement can have a profound impact on an individual's quality of life and ability to perform daily and recreational activities.

Several patient reports included in the case data allude to a treatment approach that addresses biomechanical factors beyond the knee joint itself. Comments such as 'they fixed the hip mechanics' (Cases 4, 5, 10, 11) and mentions of 'hip and pelvic misalignment' as a source of knee pain (Cases 7, 9, 11) suggest that the clinical protocol may have involved assessing and treating the entire kinetic chain. This is consistent with a modern understanding of knee pathology, where dysfunction at the hip or ankle can create compensatory stress at the knee. The positive outcomes may reflect the efficacy of addressing these root biomechanical causes rather than solely focusing on the site of pain.

The results are encouraging when viewed in the context of conservative care goals. Patients in this series, including some who were reportedly considering surgery, achieved significant relief through non-invasive means. While this study's design prevents a definitive conclusion, it indicates that this model of chiropractic care may serve as a valuable option for patients with knee pain, potentially reducing the need for more invasive procedures. These findings align with a broader clinical shift towards exhausting conservative options before proceeding with surgery. The results provide a basis for future prospective research to validate these observations in a controlled setting.

Limitations

The conclusions drawn from this study must be interpreted in light of several key limitations. First, its retrospective nature means there was no control over data collection methods and a reliance on existing clinical records. Second, as a case series, there was no control group, making it impossible to definitively attribute the observed improvements to the chiropractic intervention alone. The natural history of the condition, placebo effects, or concomitant self-care could have contributed to the outcomes. Third, the study was conducted at a single clinic, which may limit the generalizability of the findings to other patient populations or clinical settings. Fourth, the primary outcome measure was self-reported pain, which is inherently subjective. Finally, there is a potential for selection bias, as the series includes patients who completed a course of care, possibly excluding those who discontinued treatment due to a lack of perceived improvement.