OBJECTIVE: To evaluate the effectiveness of manual therapies in the treatment of nonspecific neck pain. MATERIALS AND METHODS: Medline and the Cochrane Library were searched for randomized controlled trials of manual therapy or mobilization, used alone or with exercises to treat pain and functional impairment related to nonspecific neck pain. Cochrane Back Review Group criteria were used to assess the quality of the trials and the level of evidence (unclear, limited, moderate, or high) for short-, medium-, and long-term effects. RESULTS: Of 27 identified trials, 18 were of high quality. In acute neck pain, effective treatments were thoracic manipulation combined with electrothermal therapy in the short term and cervical manipulation in the long term. In chronic neck pain and neck pain of variable duration, both pain and function improved consistently at all follow-up time points. None of the manual therapies used alone or in combination was superior over the others. In the long term, exercises alone or combined with manual therapies were superior over manual therapies used alone. CONCLUSION: Manual therapies contribute usefully to the management of nonspecific neck pain. The level of evidence is moderate for short-term effects of upper thoracic manipulation in acute neck pain, limited for long-term effects of neck manipulation, and limited for all techniques and follow-up durations in chronic neck pain.
OBJECTIVE: To evaluate the effectiveness of manual therapies in the treatment of nonspecific neck pain. MATERIALS AND METHODS: Medline and the Cochrane Library were searched for randomized controlled trials of manual therapy or mobilization, used alone or with exercises to treat pain and functional impairment related to nonspecific neck pain. Cochrane Back Review Group criteria were used to assess the quality of the trials and the level of evidence (unclear, limited, moderate, or high) for short-, medium-, and long-term effects. RESULTS: Of 27 identified trials, 18 were of high quality. In acute neck pain, effective treatments were thoracic manipulation combined with electrothermal therapy in the short term and cervical manipulation in the long term. In chronic neck pain and neck pain of variable duration, both pain and function improved consistently at all follow-up time points. None of the manual therapies used alone or in combination was superior over the others. In the long term, exercises alone or combined with manual therapies were superior over manual therapies used alone. CONCLUSION: Manual therapies contribute usefully to the management of nonspecific neck pain. The level of evidence is moderate for short-term effects of upper thoracic manipulation in acute neck pain, limited for long-term effects of neck manipulation, and limited for all techniques and follow-up durations in chronic neck pain.
Authors: Ian D Coulter; Cindy Crawford; Howard Vernon; Eric L Hurwitz; Raheleh Khorsan; Marika Suttorp Booth; Patricia M Herman Journal: Pain Physician Date: 2019-03 Impact factor: 4.965
Authors: M R Gudavalli; T Potluri; G Carandang; R M Havey; L I Voronov; J M Cox; R M Rowell; R A Kruse; G C Joachim; A G Patwardhan; C N R Henderson; C Goertz Journal: Evid Based Complement Alternat Med Date: 2013-08-20 Impact factor: 2.629
Authors: Anita Gross; Theresa M Kay; Jean-Philippe Paquin; Samuel Blanchette; Patrick Lalonde; Trevor Christie; Genevieve Dupont; Nadine Graham; Stephen J Burnie; Geoff Gelley; Charles H Goldsmith; Mario Forget; Jan L Hoving; Gert Brønfort; Pasqualina L Santaguida Journal: Cochrane Database Syst Rev Date: 2015-01-28