+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

The effectiveness of manual physical therapy and exercise for mechanical neck pain: a randomized clinical trial



The effectiveness of manual physical therapy and exercise for mechanical neck pain: a randomized clinical trial



Spine 33(22): 2371-2378



Randomized clinical trial. To assess the effectiveness of manual physical therapy and exercise (MTE) for mechanical neck pain with or without unilateral upper extremity (UE) symptoms, as compared to a minimal intervention (MIN) approach. Mounting evidence supports the use of manual therapy and exercise for mechanical neck pain, but no studies have directly assessed its effectiveness for UE symptoms. A total of 94 patients referred to 3 physical therapy clinics with a primary complaint of mechanical neck pain, with or without unilateral UE symptoms, were randomized to receive MTE or a MIN approach of advice, motion exercise, and subtherapeutic ultrasound. Primary outcomes were the neck disability index, cervical and UE pain visual analog scales (VAS), and patient-perceived global rating of change assessed at 3-, 6-, and 52-weeks. Secondary measures included treatment success rates and post-treatment healthcare utilization. The MTE group demonstrated significantly larger reductions in short- and long-term neck disability index scores (mean 1-year difference -5.1, 95% confidence intervals (CI) -8.1 to -2.1; P = 0.001) and short-term cervical VAS scores (mean 6-week difference -14.2, 95% CI -22.7 to -5.6; P = 0.001) as compared to the MIN group. The MTE group also demonstrated significant within group reductions in short- and long-term UE VAS scores at all time periods (mean 1-year difference -16.3, 95% CI -23.1 to -9.5; P = 0.000). At 1-year, patient perceived treatment success was reported by 62% (29 of 47) of the MTE group and 32% (15 of 47) of the MIN group (P = 0.004). An impairment-based MTE program resulted in clinically and statistically significant short- and long-term improvements in pain, disability, and patient-perceived recovery in patients with mechanical neck pain when compared to a program comprising advice, a mobility exercise, and subtherapeutic ultrasound.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 056316010

Download citation: RISBibTeXText

PMID: 18923311

DOI: 10.1097/BRS.0b013e318183391e


Related references

Cost-Effectiveness of Manual Therapy Versus Physical Therapy In Patients With Sub-Acute and Chronic Neck Pain: A Randomized Controlled Trial. Value in Health 18(7): A669-A670, 2015

Effectiveness of manual therapy or pulsed shortwave diathermy in addition to advice and exercise for neck disorders: a pragmatic randomized controlled trial in physical therapy clinics. Arthritis and Rheumatism 53(2): 214-222, 2005

The effectiveness and cost-evaluation of manual therapy and physical therapy in patients with sub-acute and chronic non specific neck pain. Rationale and design of a Randomized Controlled Trial (RCT). Bmc Musculoskeletal Disorders 11: 14, 2010

A Comparison Between the Effects of Scapulothoracic Mobilization Plus Physical Therapy With Physical Therapy Alone in Patients With Mechanical Neck Pain: A Randomized Clinical Trial. Journal of Chiropractic Medicine 17(4): 237-243, 2019

Manual physical therapy and exercise versus electrophysical agents and exercise in the management of plantar heel pain: a multicenter randomized clinical trial. Journal of Orthopaedic and Sports Physical Therapy 39(8): 573-585, 2009

Primary care randomized clinical trial: manual therapy effectiveness in comparison with TENS in patients with neck pain. Manual Therapy 16(1): 66-73, 2011

Manual therapy, physical therapy, or continued care by the general practitioner for patients with neck pain: long-term results from a pragmatic randomized clinical trial. Clinical Journal of Pain 22(4): 370-377, 2006

Comparison of the effectiveness of a behavioural graded activity program and manual therapy in patients with sub-acute neck pain: design of a randomized clinical trial. Manual Therapy 11(4): 297-305, 2005

Comparison of the effectiveness of three manual physical therapy techniques in a subgroup of patients with low back pain who satisfy a clinical prediction rule: a randomized clinical trial. Spine 34(25): 2720-2729, 2010

Comparison of the effectiveness of three manual physical therapy techniques in a subgroup of patients with low back pain who satisfy a clinical prediction rule: study protocol of a randomized clinical trial [NCT00257998. Bmc Musculoskeletal Disorders 7: 11, 2006

Manual therapy compared with physical therapy in patients with non-specific neck pain: a randomized controlled trial. Chiropractic and Manual Therapies 25: 12, 2017

Cleland JA, Fritz JM, Kulig K, et al. Comparison of the effectiveness of three manual physical therapy techniques in a subgroup of patients with low back pain who satisfy a clinical prediction rule. A randomized clinical trial. Spine 2009;34:2720-9. Spine 35(7): 839; Author Reply 839-40, 2010

Effectiveness of manual physical therapy and exercise in osteoarthritis of the knee. A randomized, controlled trial. Annals of Internal Medicine 132(3): 173-181, 2000

Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain. A randomized, controlled trial. Annals of Internal Medicine 136(10): 713-722, 2002

Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program. Physical Therapy 85(12): 1301-1317, 2005