Systematic reviewManipulation or mobilisation for neck pain: A Cochrane Review☆
Section snippets
Background
Neck disorders are common, disabling to various degrees, and costly (Côté et al., 1998, Linton et al., 1998, Borghouts et al., 1999, Hogg-Johnson et al., 2008). A significant proportion of direct healthcare costs associated with neck disorders is attributable to visits to healthcare providers, sick leave, and the related loss of productive capacity (Borghouts et al., 1998, Linton et al., 1998, Skargren and Oberg, 1998, Côté et al., 2008). Manipulation and mobilisation are commonly used
Objectives
This update of our systematic review assessed the effect of manipulation or mobilisation alone on pain, function, disability, patient satisfaction, global perceived effect (GPE), and quality of life (QoL) in adults experiencing neck pain with or without radicular symptoms and cervicogenic headache.
Types of studies
Any published or unpublished randomised controlled trial (RCT) or quasi-RCT (QRCT), either in full text or abstract form, was included.
Types of participants
The participants were adults (18 years or older) with the following:
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Neck pain without radicular findings, including neck pain without specific cause, whiplash-associated disorder (WAD) categories I and II (Spitzer et al., 1987, Spitzer et al., 1995, Guzman et al., 2008), myofascial pain syndrome, and neck pain associated with degenerative changes (Schumacher
Description of studies
Fig. 2 and Gross et al. (2010) describe the flow of the studies from our previous updates (1011 citation postings) and this update (809 citation postings). Of 68 identified RCTs representing 114 publications, we selected 27 RCTs (1522/1805 participants analysed/randomised) representing 32 publications for manipulation or mobilisation performed as a single-modal application. All included trials were small, with fewer than 70 subjects per intervention arm. Agreement between pairs of independent
Discussion
This update investigates the effect of mobilisation or manipulation alone in the treatment of neck pain and is a co-publication of a Cochrane Review. The overall methodological quality of trials has not improved in spite of CONSORT guidelines (Schultz et al., 2010). The evidence suggests some immediate- or short-term pain relief with a course of cervical manipulation or mobilisation alone, but these benefits are not maintained over the long-term. Evidence seems to support the use of thoracic
Implications for practice
Manipulation for acute to chronic neck pain:
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cervical manipulation produces similar pain relief, functional improvements, and patient satisfaction to mobilisation
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cervical manipulation may provide short-term, but not long-term pain relief
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thoracic manipulation used alone or in combination with electrothermal or individualised physiotherapy treatments may improve pain and function
Mobilisation for neck pain of mixed duration:
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cervical mobilisation is similar to manipulation or acupuncture for pain
Acknowledgements
We are indebted to the many authors of primary studies for their support in retrieving original research. We thank our volunteers, translators, students, the Cochrane Back Review Group editors, and Lisa Carlesso and Colleen McPhee for early access to their research.
Declarations of interest: Two of our review authors are authors of included studies. Although Gert Brønfort and Jan Hoving were review authors, they were not involved in decisions about the inclusion, risk of bias assessment or data
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Cervical manipulation versus thoracic or cervicothoracic manipulations for the management of neck pain. A systematic review and meta-analysis
2024, Musculoskeletal Science and PracticeOsteopathic management of non-specific neck pain: Preliminary findings from a cross sectional study of Australian osteopaths
2024, International Journal of Osteopathic MedicineIdentifying Patient Characteristics Associated With the Occurrence of Post Treatment Non-serious Adverse Events After Cervical Spine Manual Therapy Treatment in Patients With Neck Pain
2023, Archives of Physical Medicine and RehabilitationEffects of an exercise program plus manual therapy in a patient with failed neck surgery syndrome: A case report
2023, Journal of Bodywork and Movement TherapiesCitation Excerpt :The technique was performed placing the thumbs on the facet joints of both sides. Grade I, II and III rhythmic joint mobilizations in poster to anterior and transversal directions were gradually applied, according to Maitland (Cleland et al., 2004; Gross et al., 2010; McClatchie et al., 2009). The aim was to induce a global modulation response in the central nervous system rather than targeting a specific restriction or symptomatic level (Bialosk et al., 2018).
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This paper is based on a Cochrane Review published in The Cochrane Library 2010, Issue 1 (see www.thecochranelibrary.com for information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and The Cochrane Library should be consulted for the most recent version of the review.
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COG – Cervical Overview Group: Bronfort G, Burnie SJ, Cameron ID, D’Sylva J, Dumoulin-White R, Eddy A, Ezzo J, Goldsmith CH, Graham N, Gross A, Haines T, Haraldsson B, Hildebrand C, Hoving J, Kay T, Kroeling P, Lilge L, Miller J, Morien A, Peloso P, Perry L, Radylovick Z, Santaguida P, Trinh K, Voth S, Wang E.