• Vindigni D
• Zark L
• Sundberg T
• Leach M
• Adams J
• Azari MF

• Affiliation / Deakin University. Faculty of Health. School of Psychology
• Affiliation / Karolinska Institutet. Institute of Environmental Medicine. Musculoskeletal & Sports Injury Epidemiology Center
• Affiliation / Private Practice
• Affiliation / RMIT University. School of Health and Biomedical Sciences
• Affiliation / University of South Australia. Division of Health Sciences. Department of Rural Health
• Affiliation / University of Technology Sydney. Faculty of Health. Australian Research Centre in Complementary and Integrative Medicine (ARCCIM)
• Affiliation(G) / Australia / New South Wales / Sydney
• Affiliation(G) / Australia / South Australia / Adelaide
• Affiliation(G) / Australia / Victoria / Melbourne
• Affiliation(G) / Sweden / Stockholm
• Aged
• Aged, 80 and over
• Chiropractic / Australia
• Chiropractors / Australia
• Dizziness / therapy
• Headache / therapy
• Health Personnel / psychology
• Manipulation, Spinal
• Neck Pain / therapy
• Open Access Document
• Self Report
• Surveys and Questionnaires / Australia

Background: Neck pain is a leading cause of individual and societal burden worldwide, affecting an estimated 1 in 5 people aged 70 years and older. The nature and outcomes of chiropractic care for older adults with neck pain, particularly those with co-morbid headaches, remains poorly understood. Therefore, we sought to ascertain: What proportion of Australian chiropractors’ caseload comprises older adults with neck pain (with or without headache); How are these conditions treated; What are the reported outcomes?

Methods: An online survey examining practitioner and practice characteristics, clinical patient presentations, chiropractic treatment methods and outcomes, and other health service use, was distributed to a random nationally representative sample of 800 Australian chiropractors. Quantitative methods were used to analyze the data.

Results: Two hundred eighty-eight chiropractors (response rate = 36%) completed the survey between August and November 2017. Approximately one-third (M 28.5%, SD 14.2) of the chiropractors’ patients were older adults (i.e. aged ≥65 years), of which 45.5% (SD 20.6) presented with neck pain and 31.3% (SD 20.3) had co-morbid headache. Chiropractors reported to combine a range of physical and manual therapy treatments, exercises and self-management practices in their care of these patients particularly: manipulation of the thoracic spine (82.0%); activator adjustment of the neck (77.3%); and massage of the neck (76.5%). The average number of visits required to resolve headache symptoms was reported to be highest among those with migraine (M 11.2, SD 8.8). The majority of chiropractors (57.3%) reported a moderate response to treatment in reported dizziness amongst older adults with neck pain. Approximately 82% of older adult patients were estimated to use at least one other health service concurrently to chiropractic care to manage their neck pain.

Conclusion: This is the first known study to investigate chiropractic care of older adults living with neck pain. Chiropractors report using well-established conservative techniques to manage neck pain in older adults. Our findings also indicate that this target group of patients may frequently integrate chiropractic care with other health services in order to manage their neck pain. Further research should provide in-depth investigation of older patients’ experience and other patient-reported outcomes of chiropractic treatment.

Author keywords: Chiropractic — Headache — Older adults — Neck pain — Survey

Author affiliations: DV, MFA: Chiropractic Discipline, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia; LZ: School of Psychology, Faculty of Health, Deakin University, Burwood, Melbourne, Australia; TS: Musculoskeletal & Sports Injury Epidemiology Center (MUSIC), Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; TS, ML, JA: Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia; ML: Department of Rural Health, University of South Australia, Adelaide, Australia; MFA: Private practice, Azari Chiropractics, Mount Waverley, Melbourne, Australia

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