Impact of chiropractic care on brain processing and movement performance in individuals with recurrent neck pain: A randomized control trial

The intervention will consist of spinal adjustments which will be either high-velocity, low-amplitude thrusts to the spine or pelvic joints or instrument assisted adjustments as well as myofascial release of associated muscles. Treatment will be personalized to each individual in the treatment arm since individuals may have different areas of associated joint dysfunction and associated myofascial pain. These are standard adjustment techniques used by chiropractors. These adjustment techniques have also previously been used in studies that have investigated the neurophysiological effects of chiropractic care. The entire spine and both sacroiliac joints will be assessed for the presence of spinal dysfunction and adjusted where deemed clinically necessary by a chiropractor over an 8-week period. Associated myofascial pain will be treated by manual myofascial release of “trigger point” areas. The registered chiropractor has been practicing for over 31 years and has the expertise to be providing the intervention in this study. A second chiropractor, with five to ten years of experience, will be available should the primary chiropractor experience illness or injury. The subclinical neck pain (SCNP) treatment group will receive 8 weeks of chiropractic intervention since past work has suggested that 6 to 8 weeks are required to consolidate neural changes. The treatment frequency will be twice per week, tapering off if clinically indicated, at the discretion of the treating chiropractor. Each treatment session will be approximately 20 minutes in duration with the first session being at least 45 minutes, to acquire details about their medical history and perform a physical examination and assessment of areas of spinal dysfunction and associated myofascial findings. The clinical indicators that will be used to assess the function of the spine prior to and after each chiropractic adjustment session will include assessing for tenderness to palpation of the relevant joints, manually palpating for restricted intersegmental range of motion, assessing for palpable asymmetric intervertebral muscle tension, and any abnormal or blocked joint play and end-feel of the joints. All of these biomechanical characteristics are used by chiropractors as clinical indicators of joint dysfunction. Areas of myofascial pain that have local tenderness and refer pain on palpation will be treated by the chiropractor using manually applied trigger point therapy. The chiropractic care will be performed at Ontario Tech University, where the registered chiropractors administering the treatment practice. In order to monitor adherence to the intervention, the chiropractor will provide a report of the number of sessions attended. The healthy (non-SCNP) participants will undergo the outcome measures at baseline only. The baseline outcome measures will be compared between the SCNP and healthy groups, to compare neurophysiological differences between SCNP participants and the healthy participants.