The Study: Manipulation and Mobilization for Treating Chronic Nonspecific Neck Pain: A Systematic Review and Meta-Analysis for an Appropriateness Panel.
a. Both mobilization and manipulation are frequently used methods to treat chronic nonspecific neck pain.
b. The authors performed a literature review and meta-analysis which looked at 47 randomized trials.
c. They noted that the sample size in these trials was generally small.
d. “Although this review builds on previous efforts, it adds to the literature base by including both manipulation and mobilization interventions not only in chiropractic settings, but in other noninvasive therapy settings such as osteopathy, manual therapy, and physical therapy.”
e. They concluded: “There is low to moderate quality evidence that various types of manipulation and/or mobilization will reduce pain and improve function for chronic nonspecific neck pain compared to other interventions.”
f. The authors noted that due to differences in the way the included studies were performed that it was difficult to determine the “benefit of mobilization and manipulation alone for chronic neck pain beyond other therapies.”
g. They also noted that, when considering the literature reviewed, that mobilization and manipulation appear to be safe. “However, large longitudinal studies are needed to establish safety.”
When directed at chronic nonspecific neck pain manipulation and mobilization do reduce neck pain and improve function but the evidence remains low to moderate in quality.
Does this sound familiar, of course it does. This study looked at already published literature in this area and in effect summarizes the subject. This is generally a favorable study for chiropractic which shows that manipulation/mobilization (thrust/non thrust) care should be included along with other types of care available to patients.
Reviewer: Roger Coleman DC
Editor: Mark R. Payne DC
Reference: Coulter ID, Crawford C, Vernon H, Hurwitz EL, Khorsan R, Booth MS, Herman PM. Manipulation and Mobilization for Treating Chronic Nonspecific Neck Pain: A Systematic Review and Meta-Analysis for an Appropriateness Panel. Pain Physician. 2019 Mar;22(2):E55-E70
Link to Abstract: https://www.ncbi.nlm.nih.gov/pubmed/30921975