• Ambalavanar U
• Hossinzehi H
• Murphy B

• Atlanto-Occipital Joint
• Chronic Pain
• Musculoskeletal Pain
• Open Access Document

Background: Individuals with chronic musculoskeletal pain and atlanto-occipital joint dysfunction have increased pain, anxiety, insomnia, and poor health-related quality of life, and a repeated measures study found these improved with the One-to-Zero system, which includes manipulation of atlanto-occipital joint(s) in addition to other spinal regions.

Objective: To confirm causality, a pragmatic parallel group randomized controlled trial was conducted at private practice.

Methods: 56 participants (ages 18 to 65) were randomized into Treatment (n = 27) or Wait-list control (n= 29) and completed patient-reported measures of neck pain (Neck Disability Index and Von Korff Chronic Pain Grade Scale), anxiety (Beck Anxiety Index), insomnia (Insomnia Severity Index), and quality of life (36-Item Short Form Health Survey) via Google Forms before and after the intervention (delivered until initial symptoms improved by 80% for Treatment-taking two to six weeks) or Control period (2 -weeks).

Results: Significant time-by-group interactions with greater improvements in quality of life (95% CI: -16.58, 34.46), current neck pain (95% CI: 9.16, 14.22), and neck pain intensity (95% CI: -94.06, 61.79) occurred for Treatment group vs. Control, while anxiety and insomnia showed no significant time-by-group interactions.

Conclusion: The One To Zero system improved selective outcome measures in individuals with chronic musculoskeletal problems and atlanto-occipital joint dysfunction compared to a control group.

Author keywords Chronic Musculoskeletal Pain; Spine Dysfunction; Patient reported outcomes; Spine Care; Spinal Manipulation; Randomized Controlled Trial

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