“Manipulation of the Neck and Upper Back Leads to Quicker Recovery.” So say the authors of a new study of neck pain treatment in the recent edition of the Journal of Orthopaedic and Sports Physical Therapy (JOSPT.) The focus of their study was to see how manipulation of the neck compared to mobilization when it comes to treating neck pain.
“Manipulation” of spinal joints is performed by moving the joints up to their end range of motion and providing a light/fast thrust that may or may not cause a popping sound as the joint moves. “Mobilization” is a similar treatment method but it doesn’t include the thrust at the end.
Without a question, both treatments helped the patients in the study. Overall, both had improvements in range of motion, pain levels, and disability when follow-up measurements were made 48 hours after the initial treatment. The manipulation group, however, had far greater improvements demonstrated with treatment. Here’s a peek at some of the results:
|Disability Scores||Decreased by 50.5%||Decreased by 12.8%|
|Pain Levels||Decreased by 58.5%||Decreased by 12.6%|
|Range of Motion||Increased by 20-30%||Increased by 8-11%|
As a clinician, this helps me when patients ask me if I think getting adjusted will help. In my experience, people who get adjusted get more relief… and quicker. Just, as this study shows. I know that some people still don’t like the sound of their joints when they pop, or the twisting movement, and that is exactly the reason that tools like the activator and impulse adjusting instrument were created. I use both of those in my office, and consider them to be forms of manipulation.
What I REALLY love about this study is that it moves beyond the question of whether or not manipulation is helpful. Clearly it is, and, in fact, it provides these great benefits without the use of medications.
Dunning J, DPT, MSc Manip Ther, Cleland J, PT, PhD, et al. Upper cervical & upper thoracic thrust manipulation versus non-thrust mobilization in patients with mechanical neck pain: a multi-center RCT. JOSPT 2012; 42(1):5-18.