Best-Practice Recommendations for Chiropractic Management of Patients With Neck Pain

J Manipulative Physiol Ther. 2019 Nov;42(9):635-650. doi: 10.1016/j.jmpt.2019.08.001. Epub 2019 Dec 20.


Objective: The purpose of this study was to develop best-practice recommendations for chiropractic management of adults with neck pain.

Methods: A steering committee of experts in chiropractic practice, education, and research drafted a set of recommendations based on the most current relevant clinical practice guidelines. Additional supportive literature was identified through targeted searches conducted by a health sciences librarian. A national panel of chiropractors representing expertise in practice, research, and teaching rated the recommendations using a modified Delphi process. The consensus process was conducted from August to November 2018. Fifty-six panelists rated the 50 statements and concepts and reached consensus on all statements within 3 rounds.

Results: The statements and concepts covered aspects of the clinical encounter, ranging from informed consent through diagnosis, assessment, treatment planning and implementation, and concurrent management and referral for patients presenting with neck pain.

Conclusions: These best-practice recommendations for chiropractic management of adults with neck pain are based on the best available scientific evidence. For uncomplicated neck pain, including neck pain with headache or radicular symptoms, chiropractic manipulation and multimodal care are recommended.

Keywords: Chiropractic; Neck Pain; Spinal Manipulation; Spine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chiropractic / standards*
  • Clinical Protocols / standards*
  • Consensus
  • Headache / therapy
  • Humans
  • Informed Consent
  • Manipulation, Chiropractic / standards*
  • Neck Pain / therapy*
  • Practice Guidelines as Topic / standards*