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Manipulation or mobilisation for neck pain: A Cochrane Review

Anita Gross, Jordan Miller, Jonathan D’Sylva, Stephen J Burnie, Charles H Goldsmith, Nadine Graham, Ted Haines, Gert Brønfort, and Jan L Hoving

Man Ther 15(4):19 (2010) PMID 20510644

Manipulation and mobilisation are often used, either alone or combined with other treatment approaches, to treat neck pain. This review assesses if manipulation or mobilisation improves pain, function/disability, patient satisfaction, quality of life (QoL), and global perceived effect (GPE) in adults experiencing neck pain with or without cervicogenic headache or radicular findings. A computerised search was performed in July 2009. Randomised trials investigating manipulation or mobilisation for neck pain were included. Two or more authors independently selected studies, abstracted data, and assessed methodological quality. Pooled relative risk (pRR) and standardised mean differences (pSMD) were calculated. 33% of 27 trials had a low risk of bias. Moderate quality evidence showed cervical manipulation and mobilisation produced similar effects on pain, function and patient satisfaction at intermediate-term follow-up. Low quality evidence suggested cervical manipulation may provide greater short-term pain relief than a control (pSMD -0.90 (95%CI: -1.78 to -0.02)). Low quality evidence also supported thoracic manipulation for pain reduction (NNT 7; 46.6% treatment advantage) and increased function (NNT 5; 40.6% treatment advantage) in acute pain and immediate pain reduction in chronic neck pain (NNT 5; 29% treatment advantage). Optimal technique and dose need to be determined.

Copyright © 2010 Elsevier Ltd. All rights reserved.

DOI: 10.1016/j.math.2010.04.002
Version: za2963e q8za6 q8zb5 q8zc2 q8zd3 q8ze6 q8zf3 q8zge

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