Original articleA Randomized Controlled Trial Comparing Manipulation With Mobilization for Recent Onset Neck Pain
Section snippets
Participants
Participants were recruited from 12 private physiotherapy, chiropractic, and osteopathy clinics in Sydney, Australia. All patients age 18 to 70 years presenting to the participating clinics with an episode of recent onset neck pain were assessed by the treating practitioner for suitability for treatment with neck manipulation. Only patients for whom neck manipulation was the preferred treatment were included in the trial. We defined an episode of recent onset neck pain as pain in the region
Results
One hundred eighty-two participants were recruited by 7 physiotherapists (n=125), 5 chiropractors (n=56), and 1 osteopath (n=1) from 12 primary care clinics (fig 1) between October 2006 and June 2008. The clinics were located across a broad geographic area that included a diverse urban population. One participant withdrew from the study after the first treatment. The remaining participants were treated according to the trial protocol: receiving 4 treatments (n=179), ceasing treatment after
Discussion
The main finding of this study was that the inclusion of neck manipulation in a treatment regimen did not result in more rapid recovery from an episode of recent onset neck pain than mobilization techniques. In addition, neck manipulation did not result in better outcome in terms of pain, disability, function, global perceived effect, or health-related quality of life than neck mobilization.
This study tested neck manipulation as provided by experienced and well qualified practitioners in
Conclusions
Nearly half of the participants in this study, irrespective of treatment allocation, did not fully recover from the episode of neck pain with which they presented. This is consistent with prognostic studies that have reported the persistent and often recurrent nature of nonspecific neck pain.27 Nonetheless, there was rapid and large improvement in pain scores in both groups from a mean score ± SD of 6.0±2.0 at baseline to 2.5±2.1 after 2 weeks of treatment. Because we did not include a placebo
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Supported by the Australian National Health and Medical Research Council (grant no. 402686) and the University of Sydney.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Trial Registration: Australian New Zealand Clinical Trials Registry, ACTRN12606000417583.
Reprints are not available from the author.