Macaulay, Jessica; Cameron, Melainie; Vaughan, Brett
A systematic review of randomised, controlled trials was undertaken to determine the effectiveness of manual therapy for mechanical neck disorders in reducing pain and disability in adult populations. Articles were included if manual therapy was performed on one group within the trial, on participants with mechanical neck pain, including neck disorders with associated headache. Studies were excluded if the cause of neck pain was serious pathology, systemic disease, or trauma, or if neck pain was associated with radicular findings, or the headache was the primary disorder. Five trials involving 995 participants were included; four of the trials were of high methodological quality according to the validated Jadad criteria. Strong evidence demonstrated that manual therapy was not significantly superior to other interventions (exercise, physical therapy, medication, short wave diathermy) for relief of neck pain. Patients who received manual therapy reported being significantly more satisfied with their care than patients who received any other single therapy. A trend across three of the studies showed that manual therapy combined with exercise returned moderately larger improvements, although not statistically significant, improvements in pain, disability and patient-perceived recovery than manual therapy alone. Results in favour of combined therapies suggest multimodal care, including manual therapy and exercise, may be a potentially useful intervention in the treatment of mechanical neck disorders.
Physical Therapy Reviews, 2007, 12(3), 261-267(7)