Nyiro L, et al. – The researchers compared outcomes in neck pain patients with 0–2 vs 2–4 and 4–12 weeks of symptoms undergoing chiropractic treatment. They concluded that the time period of 0–4 weeks of symptoms as the definition of “acute” neck pain had to be maintained. For acute as well as subacute neck pain patients, independent of the exact duration of symptoms, medium–term and long–term outcome was favourable.

• The researchers conducted this prospective cohort observational study with 1-year follow-up including 495 patients whose data were collected between October 2009 and March 2015.
• They divided patients into high-acute (0-2 weeks), mid-acute (2-4 weeks) and subacute (4-12 weeks) corresponding to duration of their symptoms at initial treatment.
• At baseline, patients completed the numerical pain rating scale (NRS) and Bournemouth questionnaire for neck pain (BQN).
• The NRS and BQN were completed along with the Patient Global Impression of Change (PGIC) scale at follow-up time points of 1 week, 1 month, 3 months, 6 months and 1 year .
• They dichotomized the PGIC responses into ‘improved’ and ‘not improved’ patients and compared between the 3 subgroups.
• They used the Chi-square test to compare improved patients between the 3 subgroups and the unpaired Student’s t-test was used for the NRS and BQN change scores.

• Compared to 2-4 weeks, the proportion of patients ‘improved’ was only significantly higher for patients with symptoms of 0–2 weeks at the 1 week outcome time point (p = 0.015).
• For patients with 2–4 weeks of symptoms, the NRS changes scores were significantly greater compared to 4–12 weeks of symptoms only at 1 week (p = 0.035).