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Chiropractic Research Review

Combination of Techniques Relieves Neck Pain

This study compared the effectiveness of three commonly used intervention techniques-intensive training of the cervical musculature, physiotherapy and spinal manipulative care-on 119 patients suffering from persistent neck pain.

All three intervention strategies were associated with a similar degree of improvement regarding self-reported pain, disability and medication use. These improvements were maintained at 4- and 12-month follow-up evaluations. Although patients in the intensive-training group demonstrated greater improvements in relative endurance of the extensor muscles, overall there were no clinical differences in outcomes or effectiveness between the three techniques.

These findings suggest that a therapeutic regimen consisting of elements of all three intervention strategies (intensive training, physiotherapy and spinal manipulation) is useful in managing patients with persistent neck pain, especially when an emphasis is placed on patient activation and exercise.

While this well-designed study compared manipulation with other interventions, it is important to note that patients in the "manipulation" group received multiple forms of care, including chiropractic manipulation, manual traction, manual treatment of tender muscles and trigger points, and spinal hygiene instructions.

Jordan A, Bendix T, et al. Intensive training, physiotherapy, or manipulation for patients with chronic neck pain. A prospective, single-blinded, randomized clinical trial. Spine, Feb. 1998;23(3), pp311-19.

Chiropractic Research Review

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