# Combined Chiropractic Care and Tai Chi for Chronic Non-Specific Neck Pain

> **NIH NIH R34** · BRIGHAM AND WOMEN'S HOSPITAL · 2022 · $259,512

## Abstract

Chronic nonspecific neck pain (CNNP), which is not due to organic pathology, is responsible for significant
direct health care costs, health care provider visits, and work-related productivity loss. Though one of the top
five chronic pain conditions in terms of prevalence and years lost to disability, to date, neck pain has received
only a small fraction of the research funding given to low back pain. Consequently, there is a limited evidence
base to guide management. Both pharmacological and non-pharmacological interventions are widely used to
manage CNNP, but effect sizes are, at best, low to moderate, and no one therapy stands out as superior.
 CNNP is best understood from a biopsychosocial framework that recognizes etiology, severity, and
outcomes as a complex and interrelated array of biological, psychological and social factors and points to the
promise of complementary and integrative health approaches for successful disease management and
treatment. Accordingly, this application explores the feasibility of pragmatically delivering and clinically
evaluating the combined impact of two widely available approaches for managing CNNP––chiropractic care
and Tai Chi (TC). These specific modalities were chosen because both individually show promise in managing
CNNP, and based on their complementary approaches, strengths, and therapeutic components, there is a
strong likelihood of additive or synergist effects when the two are delivered in a coordinated manner.
 Our long-term goal is to conduct a multi-site fully powered trial evaluating the effectiveness of chiropractic
care combined with TC training to reduce pain and disability in adults with CNNP. As a first step, we propose to
conduct a three-arm, mixed-methods pilot study. We will recruit and randomize (1:1:1) 48 adults with CNNP to
receive: 1) 10 chiropractic treatments (delivered over 16 weeks) with concurrent TC training (16 weeks of in-
person group training) plus enhanced usual care (EUC; usual care (UC) with CNNP educational materials); 2)
chiropractic care plus EUC; or 3) EUC alone. Individuals will be followed for 8 weeks after the end of their
intervention period to assess longer-term outcomes. Aim 1 will evaluate our ability to recruit a network of
chiropractors and Tai Chi instructors, refine our interventions, and assess fidelity of intervention protocols. Aim
2 will assess the feasibility of recruiting, retaining and monitoring the safety of adults with CNNP into our trial.
Aim 3 will refine data collection procedures and evaluate outcomes for future trials.
 Given the widespread availability of chiropractic and TC nationally, if proven effective, this multimodal
approach for treating CNNP could represent a practical strategy with immediate public health impact. This
application aligns with NCCIH’s 2021-2025 Strategic Plan, including advancing research on the whole person
and investigating non-pharmacological pain management strategies that can improve first-line chronic pain
man...

## Key facts

- **NIH application ID:** 10509752
- **Project number:** 1R34AT011368-01A1
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Peter Michael Wayne
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $259,512
- **Award type:** 1
- **Project period:** 2022-09-12 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10509752

## Citation

> US National Institutes of Health, RePORTER application 10509752, Combined Chiropractic Care and Tai Chi for Chronic Non-Specific Neck Pain (1R34AT011368-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10509752. Licensed CC0.

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