Manual therapy in the treatment of neck pain.

In general, manual therapies have been demonstrated to be effective for mechanical neck pain in the short term when used in combination with other treatments. No one treatment protocol has been shown to be optimal as specific types of manual therapies have not been investigated in detail. Safety is a prime consideration when applying these treatments. The risk of increased symptoms resulting from manual therapy is low (in the range of 1%-2%), with the most common symptom aggravation being vertigo or dizziness. The risk of serious complication or death from neck manipulation is extremely low (in the range of 0.0001%). Optimal levels of education, training, and competency are integral to the safe performance of manual therapy.