Exercise, the Needed Ingredient for Neck TreatmentNeck pain is a common cause of sick leave. It also results in lost work and visits to health care specialists. Manipulation and mobilization are often used to treat the problem. According to this study, such treatment isn't enough unless used with exercise.
Researchers at McMaster University in Canada looked at high quality studies of adults with neck pain. All patients were treated with neck manipulation or mobilization. Manipulation uses a thrust at the end of the joint range of motion to move the joint. Mobilization applies small movements to the joint through part or all of the motion.
The included studies were done by medical doctors, chiropractors, and physical therapists. The patients all had neck pain. Some had neck pain alone, and some had neck pain with headache. Others had whiplash disorders or neck pain with arm pain. Results were measured by pain relief, improved function, and patient satisfaction.
The authors report no difference in pain relief when manipulation or mobilization was used alone. When used together the two were better than no treatment for patients with chronic neck pain and headache. Manipulation or mobilization plus exercise gave the best results for all types of neck pain patients.
Maybe exercise is the key ingredient. Scientists aren't sure. Patients who had exercise alone had the same results as the manipulation and mobilization plus exercise group. The difference was that the manipulation and mobilization plus exercise group were happier with their results.
After reviewing 33 studies, the authors conclude that mobilization works just as well as manipulation for certain types of neck problems. Both appear to be better than no treatment. And both appear to be better than other treatments like heat or massage. Both work better when combined with exercise.
Anita R. Gross, MSc, et al. A Cochrane Review of Manipulation and Mobilization for Mechanical Neck Disorders. In Spine. July 15, 2004. Vol. 29. No. 14. Pp. 1541-1548.
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