Differences in treatment history with manipulation for acute, subacute, chronic and recurrent spine pain.

Preference for treatment protocols used in the care of spine disorders are based more upon clinical impressions than upon systematic study of the pathology or treatment efficacy. As social emphasis moves to cost containment strategies, quantitative data is necessary to give guidance for rational policy decisions. This study sets a description of the clinical experience obtained in a group practice, teaching clinic engaged in management of spine disorders. The same subjects were separately reported as being broadly representative of those seen in private using a cash payment policy. Clinical characteristics were quantified on 241 patients. A total of 149 volunteered to complete follow up evaluations. The total number of treatment sessions were tallied to case resolution on all 241 patients and were evaluated by stratifying them according to chronicity of the chief complaint. The range of treatment for all cases was 1-22. Chronic complaints required the most care, with a mean of 8.2 sessions (F = 2.833, p = .014). Thoracic disorders required approximately half the care as lordotic spine regions (F = 2.372, p = .04). No differences were observed based upon descriptive classifications of entrapment, mechanical or muscular pain. All but 25 cases reached resolution well within 6 wk, requiring a mean of 3.8 (range 1-11) additional treatment sessions.