Background
Background and objective
Definition of neural therapy
Methods
Design
Patients
Inclusion criteria
-
Patients with pain and written referral explicitly to NT from physicians or doctors of chiropractic
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Chronic condition lasting more than 3 months
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Treatment-resistant pain, i.e., pain persisting after all other evidence-based (conventional medical) measures compatible with the diagnosis (especially pain medication) have failed.
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Only patients were included whose pain was at least severe,1 regardless of their pain medication (example: If pain medication had reduced a patient’s pain from very severe to mild levels at recruitment, this patient was excluded since his pain was neither treatment-resistant nor was there any drug intolerance).
Exclusion criteria / drop-out
-
Conventional medical treatment options (in accordance with the diagnosis) have not been fully exhausted at the beginning of NT.
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To avoid a potential bias, patients with improvement of pain who started on another therapy during the one-year treatment period for a reason other than pain but with the potential to influence the pain level in a positive way (e.g. rigorous diet, psychotherapy, etc.) were excluded from the analysis.
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Discontinuation of NT due to accident, new onset of a serious disease, moving house, etc.
Intervention
Data acquisition
Statistical procedures
Results
Demographic data and the Patients’ general state of health
Sex | n | Age (years) | ||
---|---|---|---|---|
Mean (SD) | Median | Range | ||
Female | 176 | 50.1 (15.1) | 51 | 14–84 |
Male | 104 | 50.9 (14.4) | 51 | 11–90 |
Total | 280 | 50.4 (14.9) | 51 | 11–90 |
Specialties of referring physicians
Referring physicians by specialty | Frequency of referral |
---|---|
General Medicine | 147 |
Chiropractic | 38 |
Internal Medicine | 30 |
Rheumatology | 16 |
Orthopedic Surgery | 10 |
Otorhinolaryngology | 8 |
Ophthalmology | 8 |
Hand Surgery | 5 |
Pediatrics | 4 |
General Surgery | 3 |
Anesthesia (Pain Clinics) | 2 |
Gynecology | 2 |
Psychiatry | 2 |
Urology | 2 |
Neurology | 1 |
Insurance Medicine (casualty insurer SUVAa) | 1 |
Dentistry | 1 |
Symptoms and diagnoses
Diagnosis (ICD 10) | Frequency | % |
---|---|---|
1. Disorders of the spine and back | 155 | 55.3 |
2. Other disorders of the motor system | ||
Arthropathies | 18 | 6.4 |
Soft tissue disorders | 16 | 5.7 |
Osteopathies | 4 | 1.4 |
Chondropathies | 2 | 0.7 |
Systemic connective tissue disorders | 1 | 0.4 |
Total | 41 | 14.6 |
3. Headaches | ||
Atypical facial pain | 13 | 4.7 |
Chronic post-traumatic headache | 5 | 1.8 |
Cluster headache | 5 | 1.8 |
Other headaches | 5 | 1.8 |
Migraine | 4 | 1.4 |
Trigeminal neuralgia | 2 | 0.7 |
Total | 34 | 12.2 |
4. Other pain | ||
Diseases of the eye | 7 | 2.5 |
Diseases of the genitourinary system, male | 5 | 1.8 |
Diseases of the genitourinary system, female | 3 | 1.1 |
Diseases of the digestive system | 3 | 1.1 |
Other diseases | 32 | 11.4 |
Total | 50 | 17.9 |
All groups | 280 | 100 |
Duration of illness
Diagnosis code | Patients (n) | Duration of illness (months) | |
---|---|---|---|
Mean (SD) | Median | ||
Disorders of the spine and back | 155 | 64.65 (91.59) | 36 |
Other disorders of the motor system | 41 | 43.98 (55.75) | 24 |
Headache | 34 | 106.50 (130.30) | 54 |
Other pain | 50 | 49.50 (53.54) | 24 |
Total | 280 | 64.00 (88.91) | 36 |
Number of treatments
Diagnosis code | Patients (n) | Treatments | |
---|---|---|---|
Mean (SD) | Median | ||
Disorders of the spine and back | 155 | 10.00 (5.97) | 8.00 |
Other disorders of the motor system | 41 | 7.07 (4.95) | 5.00 |
Headache | 34 | 8.44 (5.12) | 8.50 |
Other pain | 50 | 8.78 (5.31) | 9.00 |
Total | 280 | 9.16 (5.69) | 8.00 |
Age | Duration of illness | |||
---|---|---|---|---|
correlation coefficient | p value * | correlation coefficient | p value | |
Duration of illness | 0.11 | 0.06 | ||
Consultations | 0.14 | 0.01 | 0.06 | 0.28 |
Change in pain
Disorders of the spine and back | Other disorders of the motor system | Headaches | Other pain | Total | ||||||
---|---|---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | n | % | n | % | |
Patients | 155 | (100) | 41 | (100) | 34 | (100) | 50 | (100) | 280 | (100) |
Change in symptoms | ||||||||||
Worsening | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | 1 | (2.0) | 1 | (0.4) |
No change | 31 | (20.0) | 11 | (26.8) | 10 | (29.4) | 8 | (16.0) | 60 | (21.4) |
Slight improvement | 32 | (20.7) | 5 | (12.2) | 5 | (14.7) | 10 | (20.0) | 52 | (18.6) |
Marked improvement | 77 | (49.7) | 15 | (36.6) | 12 | (35.3) | 22 | (44.0) | 126 | (45) |
No pain | 15 | (9.7) | 10 | (24.4) | 7 | (20.6) | 9 | (18.0) | 41 | (14.6) |
Local/segmental | Interference field | Combined | ||||
---|---|---|---|---|---|---|
n | %a | n | %a | n | %a | |
Patients | 157 | (100) | 5 | (100) | 118 | (100) |
Change in symptoms | ||||||
Worsening | 1 | (0.6) | 0 | (0.0) | 0 | (0.0) |
No change | 34 | (21.7) | 0 | (0.0) | 26 | (22.0) |
Slight improvement | 29 | (18.5) | 3 | (60.0) | 20 | (17.0) |
Marked improvement | 65 | (41.4) | 1 | (20.0) | 60 | (50.9) |
No pain | 28 | (17.8) | 1 | (20.0) | 12 | (10.2) |
Consumption of pain medication
Treatment effecta | ||||
---|---|---|---|---|
Medication intake | No success | Success | ||
n | %b | n | %b | |
No medication | 18 | (29.5) | 69 | (31.5) |
No change in medication intake | 40 | (65.6) | 10 | (4.6) |
Reduced use of (or no more need for) medication | 3 | (4.9) | 140 | (63.9) |
Increased use of medication | 0 | (0) | 0 | (0) |
Total | 61 | (100) | 219 | (100) |