Literature Synthesis: Chiropractic Management of Upper Extremity Pain

A Systematic Review by the Research Commission of the Council on Chiropractic Guidelines and Practice Parameters

Thomas Souza, DC  |  Ed Feinberg, DC, MS  |  Susan Holm, DC, MS  |  Michael Carnes, DC, MS  |  Michael Reed, DC  | Phyllis Harvey, MLS

A literature synthesis is an academically rigorous analysis of all the available scientific literature on a specific topic. Reviewers use internationally accepted tools to rate each article according to specific criteria. These include the type of study (randomized controlled trial, case series, etc), the quality of the study, size of the study and many other factors that influence the credibility and strength of the study’s conclusions. Each reviewer independently rates all the available articles, and the ratings are compared among the members of the review team. When there is disagreement among the reviewers regarding the conclusions, a formal consensus process is followed to arrive at an overall conclusion upon which all reviewers can agree. The resulting conclusions do not represent the reviewers’ own beliefs but rather what the literature actually supports. A literature synthesis is a starting point. It indicates only what we can conclude with supportable, scientific evidence. Appropriate therapeutic approaches will consider the literature synthesis as well as clinical experience, coupled with patient preferences in determining the most appropriate course of care for a specific patient.

This document is solely a survey of existing studies, and only expresses the opinion of CCGPP. It is not intended to, nor does it establish a standard of care in specific communities, specific cases, or as to the care of any particular individual or condition. Each case must be determined on the basis of a careful clinical examination and diagnosis of the patient, giving due consideration to the specific condition presented and the individual’s informed choice as to care and treatment. No part of this document is intended to support any litigation or proceeding involving the standard of care, medical necessity or reimbursement eligibility.

FULL ARTICLE: Literature Synthesis: Chiropractic Management of Upper Extremity Pain