• Mette J Stochkendahl, Henrik W Christensen, Werner Vach, Poul F Høilund-Carlsen, Torben Haghfelt, and Jan Hartvigsen.
• Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark, Part of Clinical Locomotion Network, Odense, Denmark. m.jensen@nikkb.dk
• J Manipulative Physiol Ther. 2012 May 1; 35 (4): 254-62.

ObjectiveWe have previously reported short-term follow-up from a pragmatic randomized clinical trial comparing 2 treatments for acute musculoskeletal chest pain: (1) chiropractic treatment and (2) self-management. Results indicated a positive effect in favor of the chiropractic treatment after 4 and 12 weeks. The current article investigates the hypothesis that the advantage observed at 4 and 12 weeks would be sustained after 1 year. In addition, we describe self-reported consequences of acute musculoskeletal chest pain at 1-year follow-up.MethodsIn a nonblinded, randomized controlled trial undertaken at an emergency cardiology department and 4 outpatient chiropractic clinics, 115 consecutive patients with acute chest pain of musculoskeletal origin were included. After the baseline evaluation, patients were randomized to 4 weeks of either chiropractic treatment or self-management, with posttreatment questionnaire follow-up 52 weeks later. The primary outcome measures were change in pain intensity (11-point box numerical rating scale) and self-perceived change in pain (7-point ordinal scale).ResultsBoth groups experienced decreases in pain, positive global, self-perceived treatment effect, and increases in the 36-Item Short Form Health Survey scores. No statistically significant differences were observed between groups at the 1-year follow-up, and we could not deduce a common trend in favor of either intervention.ConclusionsAt the 1-year follow-up, we found no difference between groups in terms of pain intensity and self-perceived change in chest pain in the first randomized clinical trial assessing chiropractic treatment vs minimal intervention for patients with acute musculoskeletal chest pain. Further research into health care utilization and use of prescriptive medication is warranted.Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

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