Testing Joint Motion before Neck ManipulationWho do you see for neck pain and stiffness? Many people rely on chiropractors to adjust (manipulate) the spine and get relief. Before manipulating the neck, the chiropractor tests the joint motion. Manipulation is a common form of treatment that is used when the joint doesn't have full motion.
Various health professionals, including chiropractors, medical doctors, and physical therapists, use a term called endplay to describe the motion in a joint at its end range. When a joint doesn't move smoothly all the way through its full motion, we say the joint's end range is restricted. The clinician uses his or her hands to feel the joint motion. If there is end-range stiffness or loss of motion, joint manipulation may be used.
This study questions this method of deciding when to manipulate a joint. Chiropractors in private practice teamed up with the research department of Western States Chiropractic College in Oregon. They divided patients into two groups: a study group and a control group.
The study group received manipulation based on endplay. The control group also received manipulation, but the decision was based on a pretend computer exam. In the control group endplay wasn't used as a test measure. Each patient was treated by a chiropractor one time. Neck pain and stiffness were measured before and after manipulation. Another follow-up was done at least five hours after treatment.
There was no difference between the groups. Both had improvement in neck pain and stiffness. The authors conclude that manipulation has a general effect to relieve symptoms. The success of the treatment may not always depend on joint motion.
Mitchell Haas, DC, MA, et al. Efficacy of Cervical Endplay Assessment as an Indicator for Spinal Manipulation. In Spine. June 1, 2003. Vol. 28. No. 11. Pp. 1091-1096.
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