Spinal manipulation Tx benefits older adults with neck pain

(HealthDay)—For older adults with chronic mechanical neck pain, spinal manipulative therapy (SMT) plus home exercise and advice (HEA) results in better clinical outcomes and lower costs versus supervised rehabilitative exercise (SRE) plus HEA, according to a study published in the November issue of The Spine Journal.

Brent Leininger, D.C., from the University of Minnesota in Minneapolis, and colleagues examined the cost-effectiveness of HEA, SMT plus HEA, and SRE plus HEA in a sample of 241 older adults with chronic mechanical neck pain.

The researchers found that total costs were 5 percent lower for SMT+HEA versus HEA and 47 percent lower versus SRE+HEA. Relative to HEA and SRE+HEA, SMT+HEA correlated with a greater reduction in neck pain over the year. The differences in both disability and quality-adjusted life-years (QALYs) favored SMT+HEA. At willingness to pay thresholds of $50,000 to $200,000 per QALY gained, the probability that adding SMT to HEA would be cost-effective varied from 0.75 to 0.81. Costs for SMT+HEA were 66 percent higher than HEA if adopting a health-care perspective, resulting in an incremental cost-effectiveness ratio of $55,975 per QALY gained.

"On average, SMT+HEA resulted in better clinical outcomes and lower total societal costs relative to SRE+HEA and HEA alone, with a 0.75 to 0.81 probability of cost-effectiveness for willingness to pay thresholds of $50,000 to $200,000 per QALY," the authors write.

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