Manual therapy best for some neck pain
31 May 2002
Manual therapy is better than traditional GP care for treating non-specific neck pain, Dutch research says.
People with non-specific neck pain are almost twice as likely to enjoy a successful outcome if they undergo manual therapy (passive movements designed to restore normal spinal function) rather than continued GP care involving analgesics, counselling and patient education (Annals of Internal Medicine 2002; 136: 713-22).
The study of 183 people showed that 68 per cent of those assigned to manual therapy were 'completely recovered' or 'much improved' after 7 weeks. The figure compared with 50 per cent of those people assigned to physical therapy, and 36 per cent of those receiving GP care.
Headaches, pain and arm tingling occurred more often during manual and physical therapy than in GP care, and temporary increase in neck pain lasting more than 2 days after therapy was most common after manual therapy.
Spinal manipulations (low-amplitude, high-velocity thrust techniques) were not performed, and manual therapy was performed only by physical therapists who had specialised in manual therapy.
Patients must be screened
Manual therapy is safe when used carefully for non-specific mechanical neck pain as long as patients are screened for complications, says the chair of Musculoskeletal Physiotherapy Australia Debra Shirley.
Complications included instability, fractures, cancer, rheumatoid arthritis and vertebro-basilar insufficiency.
She said ideally GPs should refer people for manual therapy to physiotherapists with postgraduate qualifications in the technique, although any physiotherapist could perform manual therapy.
Contact Musculoskeletal Physiotherapy Australia on (03) 9536 9344 for more information and for guidance on managing neck and back pain.
Last Reviewed: 31 May 2002
- 1. Medical Observer Weekly 31/5/02
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