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Medical Factors
Manual therapies including manipulation may help acute neck pain.

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At a glance:

Neck pain is the most common musculoskeletal

musculoskeletal
Involving the muscles and the skeleton. This term includes the limbs, neck, shoulders and back. 'Musculoskeletal problem' refers to many different conditions that can affect the tendons, muscles and related structures.

complaint after low back pain. Acute neck pain that is not caused by whiplash usually gets better on its own. This study found evidence that manual therapies, including manipulation, may improve pain and range of motion for this condition.

Perspectives:

Employee

Neck pain is a common condition. This review looked specifically at neck pain that is not caused by whiplash. The condition might "spring up' from nowhere, develop gradually, or begin after a sudden strain. It usually gets better on its own and returning to normal activities is the best treatment. Manual therapy, including spinal manipulation, can improve symptoms such as pain and limited range of motion.

To prevent neck pain, exercise regularly.

Employer

Most people with neck pain (which is not caused by whiplash) will recover well without treatment. To relieve symptoms, manual therapy such as spinal manipulation can be effective. Encouraging workers to change postures and take short stretching breaks are strategies that can reduce neck pain in the workplace.

Treater

This systematic review

systematic review
A comprehensive review of research studies in a particular area. The review follows guidelines to ensure the studies included are valid.

found that manual therapy can improve pain and range of motion in patients with acute

acute
A condition develops quickly and is often of short duration. The opposite of acute is chronic, which refers to a long term problem continuing for months to years.

neck pain that is not caused by whiplash. It is important that patients understand their condition is usually self-limiting, that treatments such as these treatments provide symptomatic relief and that it is important to return to activity as soon as possible.

Insurer

Neck pain is very common – this study estimates that 70% of people will experience the condition at some point in their lives. Most people with neck pain that is not caused by whiplash will recover well without treatment. To relieve symptoms, manual therapy such as spinal manipulation can be effective.

Original Article, Authors & Publication Details:

H. T. Vernon, B. K. Humphreys and C. A. Hagino (2005).

A systematic review of conservative treatments for acute neck pain not due to whiplash. Journal of Manipulative and Physiological Therapeutics; 28(6):443-448.

Background, Study Objectives, How It Was Done:

After low back pain, neck pain is the second most common musculoskeletal complaint. About 70% of people have neck pain at some point in their lives. This study estimated that at any given time about 10% of people are experiencing neck pain that is not due to whiplash.

Acute neck pain that is not due to whiplash is usually self-limiting, meaning it gets better on its own without treatment. The pain may develop during ordinary activities at home or work, due to a sudden strain

strain
Injury to a muscle in which the muscle fibres tear or become irritated as a result of overstretching or wrenching

or gradually over time.

Treatments that are used for acute neck pain include medication, collars, traction.

Traction
Used as a treatment for back pain but not widely regarded as effective. The body's weight is suspended from a part of the lower body (e.g. the feet) in order to use gravity to decompress the joints.

ultrasound, acupuncture, electrotherapy, manual therapies and exercises.

There are various types of manual therapies, some of which target the joints (e.g. manipulation, mobilization and manual traction) and some which target the soft tissues

tissue
Collection of cells that perform a similar function. e.g. epithelium (skin), connective tissue (blood, bone), muscle

(e.g. massage, trigger-point therapy, shiatsu). Therapeutic exercises aim to improve target flexibility, strength, endurance and co-ordination.

This systematic review combines the evidence from randomized controlled trials

randomized controlled trial

A research study that groups participants into "treatment" and "control" groups. The treatment group is given an intervention

intervention
A treatment or management program. Interventions often combine several approaches. In this field approaches include training in problem solving, adaptation of work duties, graded activity, an exercise and stretching program and pain relief.

while the control group is not. Outcomes for the groups are compared to see the difference made by the intervention. This ensures that the study results are valid and not influenced by another factor. Example: In a randomised controlled trial of treating back pain with anti-inflammatory tablets 60% of people improved over two weeks. However, if 60% of the control group who were given a placebo

placebo
A substance containing no active drug, administered as a control to a patient participating in a research study. Using a placebo helps researchers assess whether the treatment under study is actually responsible for any improvement or worsening of the problem.

also improved over two weeks the results indicate the tablets did not help overall. It is important participants to be given the medication are chosen randomly. If there was a reason for putting those people in that group, such as worse pain, it might alter the results.

testing manual treatments, manipulation and exercises for acute neck pain not caused by whiplash. Four studies were accepted for inclusion in the review, based on their quality and relevance.

Study Findings:

3 of the studies evaluated spinal manipulation or manual therapy, by comparing it to Transcutaneous Electrical Nerve Stimulation, medication, a collar or a placebo treatment.

Manual therapies improved pain and range of motion more than Transcutaneous Electrical Nerve Stimulation, medication, collar or placebo.

Transcutaneous Electrical Nerve Stimulation decreased pain more than a collar.

Conclusions:

Research into the best treatments for acute neck pain that is not caused by whiplash is scarce. This review found evidence that manual therapies, including manipulation, can reduce pain and increase range of motion. Transcutaneous Electrical Nerve Stimulation may also decrease pain.

References:

PubMed Abstract

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