Treatment Of Mechanical Neck Pain Research Articles

Effectiveness Of Pilates and Range of Motion Excercises in Improving Mechanical Pain and Functional Performance in Neck Pain

BACKGROUND: Mechanical neck pain is a common problem in the world today and there are various studies that shows the high incidence and prevalence of mechanical neck pain which affects people daily activities. Neck pain is characterized by pain and limited range of movement at neck. This condition causes reduction in quality of life, leading to emotional and psychological changes and difficulties at work. Generally, the therapeutic methods for the treatment of mechanical neck pain consists of stretching and strengthening of neck muscles, cervical mobilization exercises, and electrotherapy. The Pilates is to improve general body flexibility and health by emphasis on stability to the center of the body (i.e. the core), posture, and coordination of breathing with movement. It heals the individual physically, emotionally and psychologically. METHOD: 30 participants were taken who were aged 18 – 40 years and had neck pain more than 3 months. The participants were given Pilates and range of motion exercises for 3 weeks. Outcome measure were calculated using Visual Analog Scale (VAS) and Neck Disability Index (NDI). RESULT: As a result, both the groups showed significant improvement but Pilates group shows more improvement in all the parameters of reducing pain & improving functional performance. CONCLUSION: However, we could conclude that, Pilates exercises had a significant impact on reducing cervical pain and disability among patients with chronic neck pain, with 3 weeks of the exercises.

Comparison between upper thoracic spine mobilization and the Ergon technique in the treatment of mechanical neck pain

Upper thoracic spine mobilization and the Ergon technique are used to treat mechanical neck pain in order to speed recovery, promote tissue healing and improve range of motion. There have been a few studies discussing the Ergon IASTM and upper thoracic spine mobilization in patients with neck pain, but none compared the aforementioned techniques in the treatment of mechanical neck pain. This clinical trial was conducted on a sample of thirty participants (16 females and 14 males) with mechanical neck pain who were randomly divided into two groups: Upper Thoracic Spine Mobilization (n=15) and Ergon Technique (n=15). Twelve sessions were delivered to all participants over a four-week period, three days per week. Before and after treatment, pain severity was measured by Numeric Pain Rating Scale (NPRS), cervical spine's active range of motion was measured by using a Cervical Range of Motion (CROM) device, and cervical spine's disability index was measured by Neck Disability Index (NDI). The statistical analysis was carried out using the Statistical Package for Social Sciences (SPSS) version 25. Both groups showed improvement in neck pain, reduced functional disability and increased cervical range of motion after treatment. The upper thoracic spine mobilization group had significantly better results in terms of cervical left lateral flexion and left rotation ranges of motion, while the Ergon Technique group had significantly better results in terms of improvement of neck pain and reduction in functional disability. In conclusion, the upper thoracic spine mobilization was effective at increasing the range of motion of the cervical region, while the Ergon technique was effective at relieving pain and dysfunction in the cervical spine in patients with mechanical neck pain. Upper thoracic spine mobilization and the Ergon technique are used to treat mechanical neck pain in order to speed recovery, promote tissue healing and improve range of motion. There have been a few studies discussing the Ergon IASTM and upper thoracic spine mobilization in patients with neck pain, but none compared the aforementioned techniques in the treatment of mechanical neck pain. This clinical trial was conducted on a sample of thirty participants (16 females and 14 males) with mechanical neck pain who were randomly divided into two groups: Upper Thoracic Spine Mobilization (n=15) and Ergon Technique (n=15). Twelve sessions were delivered to all participants over a four-week period, three days per week. Before and after treatment, pain severity was measured by Numeric Pain Rating Scale (NPRS), cervical spine's active range of motion was measured by using a Cervical Range of Motion (CROM) device, and cervical spine's disability index was measured by Neck Disability Index (NDI). The statistical analysis was carried out using the Statistical Package for Social Sciences (SPSS) version 25. Both groups showed improvement in neck pain, reduced functional disability and increased cervical range of motion after treatment. The upper thoracic spine mobilization group had significantly better results in terms of cervical left lateral flexion and left rotation ranges of motion, while the Ergon Technique group had significantly better results in terms of improvement of neck pain and reduction in functional disability. In conclusion, the upper thoracic spine mobilization was effective at increasing the range of motion of the cervical region, while the Ergon technique was effective at relieving pain and dysfunction in the cervical spine in patients with mechanical neck pain.

Effects of Sleep Quality and Mental and Physical Fatigue on Mechanical Neck Pain

Objective: Mechanical neck pain is a very common problem in society and can lead to disability. In modern societies, increasing expectations from individuals in work, family and social life have brought along sleep disorders, mental and physical fatigue. The aim of our study was to examine the effects of sleep disorder, mental and physical fatigue on mechanical neck pain.Method: Two hundred fifty-two individuals with mechanical neck pain having a mean age of 28.01±9.97 years were included in our study. Neck Disability Index, Chalder Fatigue Scale, and Pitssburg Sleep Quality Index were applied to all individuals.Results: According to the regression analysis results, only the mental fatigue sub-dimension of the Chalder Fatigue Scale was associated with increased Neck Disability Index score (β=0.169, p=0.036). Pitssburgh Sleep Quality Index and the physical sub-dimension of Chalder Fatigue Scale were found not to have a significant effect on Neck Disability Index score (p>0.05).Conclusion: Mental fatigue was found among the independent determinants of neck disability. Therefore, a more holistic approach including mental fatigue should be adopted in the treatment of mechanical neck pain.

Effect of Ardh Matsyendrasana, OM Chanting and Proprioceptive Neuromuscular Facilitation on Cervical Range of Motion and Health Related Quality of Life in Subacute Bilateral Mechanical Neck Pain: A Randomised Controlled Trial

Introduction: Mechanical Neck pain is evoked by sustained poor neck posture, movement of neck, and on palpation. Patient experiences pain in cervical muscles with absence of any pathology. Previous studies found that Proprioceptive Neuromuscular Facilitation (PNF) as well as yoga asana is effective for treatment of mechanical neck pain. This study was designed to assess the efficacy of neck PNF, Ardh Matsyendrasana with OM chanting and its combination approach on neck Range Of Motion (ROM) and quality of life of people suffering from subacute mechanical neck pain. Aim: To assess the effectiveness of Ardh Matsyendrasana, OM chanting and PNF and its combined approach on neck ROM and quality of life of patients suffering from bilateral subacute mechanical neck pain. Materials and Methods: This randomised controlled trial was conducted in Amity Institute of Physiotherapy Out Patient Department (OPD), Amity University, Noida, Uttar Pradesh, India. The study was conducted between January 2019 to January 2021. A total of 103 subjects of bilateral mechanical neck pain were randomised into four groups (group 1-4): PNF group (n=27), yoga group performed Ardh Matsyendrasana with OM chanting (n=25), combined group performed both PNF, Ardh Matsyendrasana with OM chanting (n=26) and control group (n=25) performed bilateral active stretching of neck muscles. Interventions were given for four weeks with five sessions per week. Outcome measures were Cervical Range of Motion (CROM) assessed using digital cervical goniometer and health related quality of life assessed using SF- 36v2 tool. Data were assessed at baseline and four weeks post intervention. Within group analysis was done using paired t-test with p<0.05 was considered significant. Results: Both CROM measurements as well as health related quality of life parameters showed statistically significant improvement for all four groups from baseline to four weeks postintervention (p<0.05). Improvement scores showed that the group performing Ardh Matsyendrasana with OM chanting and combined PNF neck patterns with Ardh Matsyendrasana and OM chanting showed better improvement in neck flexion, extension, right and left lateral flexion and right and left rotation ROM as well improved mental and physical component scores of quality of life parameter for bilateral subacute mechanical neck pain cases. Conclusion: In this study, neck PNF patterns, Ardh Matsyendrasana with OM chanting, combined PNF, Ardh Matsyendrasana with OM chanting and active stretching exercise of neck muscles specifically sternocleidomastoid and rhomboids, all interventions were found to be effective in improving neck ROM and quality of life in bilateral subacute mechanical neck pain post four weeks of intervention. But yoga group (Ardh Matsyendrasana with OM chanting) and combined group which performed combined PNF neck pattern with Ardh Matsyendrasana and OM chanting proved them to be an effective treatment for improving CROM and health related quality of life in bilateral subacute mechanical neck pain.

Effect of manipulative treatment in patients with mechanical neck pain: a systematic review

Introduction: The neck pain especially of mechanical origin (related to the joints of the spine) interfere in health and quality of life of individual widely affecting the population. Objective: Analyze through a systematic review the effectiveness of manipulation as a therapeutic tool in neck pain. Method: The search was performed using the following databases: Scientific Electronic Library Online (SCIELO), Virtual Health Library (BIREME), PubMed (MEDLINE) and Google Scholar with the descriptors “Cervical manipulation”, as well as associated with the word “joint”, in the last 14 years (2001 to 2015). The search resulted in 446 articles of which 49 were selected for reading the full text, but only 10 articles contemplated the methodological criteria. There were included studies that approach about the neck pain, using manipulation associated with physiotherapy techniques. Reviews, master and doctoral thesis and Completion of Course Work were excluded, as well as studies involving animals. Results: The articles included in this study were submitted to methodological quality analysis of the PEDro scale, in which all items have average higher than or equal to six. The sample size ranges from 6 to 96 subjects with age between 18 and 65 years old. Regarding the gender of patients the prevalence was 35.71% for males and 64.28% for females, being this one predominant in the studies included in the research. The majority of the evaluated articles proved to be favorable to cervical manipulation with improvement of pain in 48.9% of patients in primary care and about 75% decreased in 6 months, as well as improvement of functional limitation. Conclusions: The cervical manipulation proved to be an important and effective technique in the treatment of mechanical neck pain, because it can minimize the painful condition and restore range of motion.

Effect of Dry Needling Injection and Kinesiotaping on Pain and Quality of Life in Patients with Mechanical Neck Pain

Background: Dry needling (DN) is a commonly used technique by clinicians for the treatment of mechanical neck pain (MNP) by targeting trigger points and nontrigger point structures. It is a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying trigger points, muscular and connective tissues without the use of injectate. Another popular treatment technique used in the management of musculoskeletal pathologies is kinesiotaping (KT). Although its popular, there is minimal scientific evidence supporting KT for neck pain. Although there are a few studies regarding KT for neck pain in literature, there is a lack of randomized, controlled studies evaluating KT for neck pain. Objectives: To evaluate the effect of KT on posterior cervical spine and DN into a posterior paracervical muscle of patients with MNP. Study Design: Randomized clinical study. Setting: Physical medicine and rehabilitation center. Methods: Seventy-two patients (17 men, 55 women) were randomly assigned to DN or KT treatment groups. Numeric Rating Scale (NPS-11), Neck Disability Index (NDI), range of motion (ROM), Short Form36 Quality of Life Scale, and Beck Depression Inventory (BDI) were assessed before the intervention and one month postintervention. Results: Before treatment, there was no difference between groups in NPS-11, NDI, and BDI scores; however, ROM of the DN group was greater than ROM of the KT group (P < 0.05). After treatment, significant improvement was observed in all variables for both of the groups, except ROM in the DN group (P < 0.05). The KT group showed greater ROM compared with the DN group (P < 0.05). The preand posttreatment results showed that the KT group was significantly superior for the differences on ROM and NDI (P < 0.05); however, each group showed better results after treatment (P < 0.05). Limitations: First, we did not include a control or placebo group. Second, patients were followed up for only 4 weeks. Third, we used a sample of convenience from one clinic, which may not be representative of the entire population of individuals with MNP. Conclusions: In this study, both methods were found to be effective on pain, mood, and quality of life, and KT was found to be superior to DN in MNP in terms of increasing ROM and decreasing disability

Effect of post isometric relaxation technique in the treatment of mechanical neck pain

Abstract Background and purpose: Neck pain is one of the most common musculoskeletal disorders in the general population which have large economic burden on the health care system. So, the purpose of the study was to

Comparison In Effect of Ocular Muscle Exercise With Conventional Treatment in Mechanical Neck Pain with Myopic Individuals

purpose of the study To compare the effectiveness of conventional treatment with ocular muscle exercise in the treatment of mechanical neck pain in myopic individuals. Methods: The Study included 14 young patients and were divided into two groups .Group A received conventional treatment(hot pack stretching,AROM and isometric exercises).Group B received ocular and conventional treatment(hot pack stretching,AROM and isometric exercises, ocular muscle exercises). All the outcome variables i.e. neck disability index.numerical pain rating scales,near point convergence were measured at 0 (pre-test), 7 sittinf and 15 sitting. Results: The result of the study suggests the significant result within the groups after 3 week of treatment protocol. Conclusion: The results of the study suggest that both the groups show improvement but ocular muscle exercises are beneficial for improving neck disablilit scales,numerical pain rating scales,near point convergence .

Effectiveness of Two Combined Techniques of Ultrasound Therapy and Stretching in the Treatment of Mechanical Neck Pain: A Randomized Controlled Trial

Background: The application of heat prior to or during stretching is advocated to enhance muscles’ flexibility and decrease pain. Yet, the difference in the timing of heat application with stretching has not been investigated in chronic mechanical neck pain. Objective: To compare the effectiveness of two combined treatment techniques of ultrasound (US) therapy and static stretch (SS) of the upper fibers of trapezius (UT) in the treatment of chronic mechanical neck pain. Methods: Fifty patients (their age range of 20 to 35) with chronic mechanical neck pain were randomized in two groups: Group I received a simultaneous application of US therapy and SS of the UT muscle; Group II received US therapy followed by SS of the UT muscle. Neck pain, neck disability and side-bending range of motion (ROM) were measured before and after the intervention. Results: All outcome measures improved similarly in both groups, with the exception that greater improvements (P

Additional effects of kinesiotaping to mobilization techniques in chronic mechanical neck pain

Objectives: The aim of this study was to investigate the additional e ects of kinesio taping to mobilization techniques on muscle activation of deep cervical exors and neck pain in chronic mechanical neck pain. Methods: Twenty-eight participants with mechanical neck pain were included in this study. The participants were randomized into two groups: mobilization group (Group 1) and kinesio taping group (Group 2). Treatment for Group 1 (Mean age: 25.71±8.39 yrs) included scapular mobilization, ischemic compression for trigger points and Cyriax mobilization techniques for cervical region. Treatment for Group 2 (Mean age: 30.29±12.92 yrs) included kinesio taping, additionally. Head and neck pain were assessed by Visual Analog Scale, while the muscle activation of deep neck cervical exors was assessed by Craniocervical Flexion Test, using “Stabilizer Pressure Biofeedback” device before treatment and four days a er treatment. Inter-group di erences were analyzed by Mann Whitney U Test, and intra-group changes were analyzed by Wilcoxon Test. Also the e ect sizes of intra-group changes were analyzed. Results: There was no significant di erence between the groups for any outcome (p>0.05). Endurance of deep cervical exors improved (Group 1, p=0.018; Group 2, p=0.004), and inten - sity of headache reduced significantly, in both groups (Group 1, p=0.038; Group 2, p<0.001). E ect sizes of changes in activation of deep cervical exor muscles were d: 0.68 and d: 0.863 in Group 1 and 2, respectively. E ect sizes of changes in headache intensity were d: 0.86 and 0.83 in Group 1 and 2, respectively. Conclusions: When e ect size di erences were analyzed, it was considered that kinesio taping could be used in addition to mobilization techniques in the treatment of mechanical neck pain.

Validez y fiabilidad del informe del usuario sobre agentes físicos y modalidades de terapia manual en pacientes con cervicalgia mecánica que han recibido tratamiento fisioterápico en unidades de atención primaria

Objectives Study the validity and reliability of the information provided by patients of primary care physiotherapy compared with information from records of physical therapy on the application of physical agents and modalities of manual therapy for the treatment of mechanical neck pain. Material and methods We constructed a questionnaire that was piloted in five physiotherapy units in different primary care centers. The method of patient recruitment was convenience recruiting potential patients attending the respective primary care. A total of 176 patients with subacute or chronic mechanical neck pain were given a questionnaire or self-report, which was composed of 9 items on physical agents and modalities of manual therapy. A total of 142 patients participated (80.7% of subjects selected.) We compared self-reported data for patients with records of physical therapy, using the sensitivity and specificity levels, Kappa index and concordance. Results Generally, the sensitivity and specificity was low (< 75%) for manual therapy and high (> 75%) for physical agents. The Kappa index was acceptable (> 0,4) in some items, specifically items related to microwave, shortwave, traction, ultrasound and TENS. Conclusions A patient self-report on the treatment of mechanical neck pain may be valid for physical agents and massage, but is not valid for cervical stretching and mobilization.

A clinical trial investigating the possible effect of the supine cervical rotatory manipulation and the supine lateral break manipulation in the treatment of mechanical neck pain: A pilot study*1, *2

Objective: To evaluate the possible effect of the supine cervical rotary manipulation and the supine lateral break manipulation in the treatment of mechanical neck pain, according to subjective and objective clinical findings. Background: Delivering a supine lateral break manipulation to the ipsilateral side of an inflamed facet joint(s) that exhibits a lateral flexion fixation may result in pain and/or discomfort to the patient. Thus the proposed alternative is a supine cervical rotary manipulation delivered on the ipsilateral side or a supine lateral break manipulation delivered on the contralateral side of the relevant joint(s). Design: Randomized, comparative clinical trial. Subjects: Two groups of 15 subjects diagnosed with mechanical neck pain. Intervention: The diagnosis of mechanical neck pain and the identification of lateral flexion fixations in the cervical spine were made with conventional clinical evaluation, including motion palpation. Group A received a cervical rotary manipulation(s) on the ipsilateral side of the lateral flexion fixation(s), while group B received a supine lateral break manipulation(s) on the contralateral side of the lateral flexion fixation(s). Subjects received a maximum of 10 treatments over a 4-week treatment period. Outcome Measures: Both treatment groups were assessed with subjective (Numerical Pain Rating Scale 101, McGill Short-Form Pain Questionnaire and the Canadian Memorial Chiropractic College Neck Disability Index) and objective (cervical range of motion goniometer and algometer) measurement parameters at the initial consultation (before any treatment), the final consultation, and at a 1-month follow-up consultation. Statistical analysis was conducted at a 95% confidence level (α =.05) with the non-parametric 2-tailed Wilcoxon signed ranks test, the Mann-Whitney U test, and descriptive statistics. Two-tailed power analysis was conducted after the fact, where a confidence level of 80% (β =.20) was considered satisfactory. Results: Intragroup analysis indicated a significant difference between the initial consultation data and the final consultation data for the subjective data, indicating an effect. Analysis of the objective data did not reveal any significant difference. Intergroup analysis did not reveal any significant difference between the 2 groups when comparing the data of the initial consultation and the final consultation, indicating that both treatments had a similar or equal effect. Power analysis was not satisfactory for most data, indicating the possibility of many Type II errors. Conclusion and Recommendations: Statistically, the results suggested that both treatments had an effect but that neither group showed a benefit over the other. However, because of the unsatisfactory power of the study, conclusions are to be drawn with caution. Clinical significance supported the statistical outcomes where it was suggested that both treatments had an effect and that neither treatment had a greater effect. A larger sample size and the inclusion of a placebo group is recommended to reveal true treatment outcomes and trends. (J Manipulative Physiol Ther 2000;23:324–31)

Chiropractic management of mechanical neck and low-back pain: A retrospective, outcome-based analysis*1

Background: Evidence suggests that spinal manipulation is an effective treatment for mechanical neck and low-back pain (LBP). Treatment efficacy is important to establish for these symptoms because combined they account for a considerable amount of disability and substantial associated direct and indirect costs to society. Objective: The purpose of this study was to examine the outcome of patients undergoing chiropractic treatment for mechanical neck or LBP. Design and Setting: A retrospective, outcome-based analysis was done for patients seeking care at a private chiropractic practice over a 1-year period. A total of 512 files were reviewed, with 119 patients selected for inclusion. Patients were included if their chief symptom was uncomplicated mechanical neck or LBP. Diagnoses included cervical, lumbar, or sacroiliac joint sprain/strain (International Code of Diagnostics version 9 [ICD-9] code: 847.1, 847.3, 846.1, respectively), discogenic LBP (ICD-9: 722.1), and headaches (ICD-9: 784.0) because many patients with neck pain presented with concomitant headaches. Disability and pain were measured with the modified Oswestry scale (for the patients with LBP), Neck Disability Index, and an 11-box visual analogue pain scale before and after treatment. Treatment consisted of spinal manipulation, various soft-tissue techniques, home-care instructions, and ergonomic and return-to-activity advice, including rehabilitative exercises. Patients received an average of 12 treatments over a 4-week period. Statistical analysis was performed on pretreatment and posttreatment values for both disability and pain. Stratification was based on duration (acute/subacute, chronic, acute exacerbation of a chronic condition) and severity (mild, moderate, or severe) of symptoms. Results: Statistically significant reductions in disability and pain scores were achieved in all groups. An average 52.5% and 52.9% reduction in pain and disability, respectively, was achieved in the low-back group. The chronic LBP group realized a less statistically significant reduction of pain and disability (19.7% and 19.8%, respectively) than the acute/subacute (66.8% and 62.5%) or the chronic/recurrent group (56.5% and 63.4%). The differences were statistically significant. Patients with neck pain had an average 53.8% and 48.4% reduction in their pain and disability, respectively. Patients with concomitant neck pain and headaches had statistically significant higher pretreatment and posttreatment disability and pain scores than those with only neck pain. There was no statistically significant difference in outcomes between groups stratified according to pain intensity. Conclusions: Patients attending a private chiropractic clinic for treatment of mechanical neck pain or LBP had statistically significant reductions in their pain-related disability after treatment. These results indicate that chiropractic manipulation is beneficial for the treatment of mechanical neck pain and LBP. However, care must be taken when drawing conclusions from these outcomes. The study design does not account for the natural history of low back- or neck pain-related disability and therefore does not allow for claims of treatment efficacy. In addition, it has been suggested that patients presenting to medical doctors with these symptoms have significant overlying comorbidity when compared with patients presenting to a chiropractor. (J Manipulative Physiol Ther 2000;23:307–11)

Chiropractic management of mechanical neck and low-back pain: A retrospective, outcome-based analysis

Background: Evidence suggests that spinal manipulation is an effective treatment for mechanical neck and low-back pain (LBP). Treatment efficacy is important to establish for these symptoms because combined they account for a considerable amount of disability and substantial associated direct and indirect costs to society.Objective: The purpose of this study was to examine the outcome of patients undergoing chiropractic treatment for mechanical neck or LBP.Design and Setting: A retrospective, outcome-based analysis was done for patients seeking care at a private chiropractic practice over a 1-year period. A total of 512 files were reviewed, with 119 patients selected for inclusion. Patients were included if their chief symptom was uncomplicated mechanical neck or LBP. Diagnoses included cervical, lumbar, or sacroiliac joint sprain/strain (International Code of Diagnostics version 9 [ICD-9] code: 847.1, 847.3, 846.1, respectively), discogenic LBP (ICD-9: 722.1), and headaches (ICD-9: 784.0) because many patients with neck pain presented with concomitant headaches. Disability and pain were measured with the modified Oswestry scale (for the patients with LBP), Neck Disability Index, and an 11-box visual analogue pain scale before and after treatment. Treatment consisted of spinal manipulation, various soft-tissue techniques, home-care instructions, and ergonomic and return-to-activity advice, including rehabilitative exercises. Patients received an average of 12 treatments over a 4-week period.Statistical analysis was performed on pretreatment and posttreatment values for both disability and pain. Stratification was based on duration (acute/subacute, chronic, acute exacerbation of a chronic condition) and severity (mild, moderate, or severe) of symptoms.Results: Statistically significant reductions in disability and pain scores were achieved in all groups. An average 52.5% and 52.9% reduction in pain and disability, respectively, was achieved in the low-back group. The chronic LBP group realized a less statistically significant reduction of pain and disability (19.7% and 19.8%, respectively) than the acute/subacute (66.8% and 62.5%) or the chronic/recurrent group (56.5% and 63.4%). The differences were statistically significant. Patients with neck pain had an average 53.8% and 48.4% reduction in their pain and disability, respectively. Patients with concomitant neck pain and headaches had statistically significant higher pretreatment and posttreatment disability and pain scores than those with only neck pain. There was no statistically significant difference in outcomes between groups stratified according to pain intensity.Conclusions: Patients attending a private chiropractic clinic for treatment of mechanical neck pain or LBP had statistically significant reductions in their pain-related disability after treatment. These results indicate that chiropractic manipulation is beneficial for the treatment of mechanical neck pain and LBP. However, care must be taken when drawing conclusions from these outcomes. The study design does not account for the natural history of low back- or neck pain-related disability and therefore does not allow for claims of treatment efficacy. In addition, it has been suggested that patients presenting to medical doctors with these symptoms have significant overlying comorbidity when compared with patients presenting to a chiropractor.

A clinical trial investigating the possible effect of the supine cervical rotatory manipulation and the supine lateral break manipulation in the treatment of mechanical neck pain: A pilot study

Objective: To evaluate the possible effect of the supine cervical rotary manipulation and the supine lateral break manipulation in the treatment of mechanical neck pain, according to subjective and objective clinical findings.Background: Delivering a supine lateral break manipulation to the ipsilateral side of an inflamed facet joint(s) that exhibits a lateral flexion fixation may result in pain and/or discomfort to the patient. Thus the proposed alternative is a supine cervical rotary manipulation delivered on the ipsilateral side or a supine lateral break manipulation delivered on the contralateral side of the relevant joint(s).Design: Randomized, comparative clinical trial.Subjects: Two groups of 15 subjects diagnosed with mechanical neck pain.Intervention: The diagnosis of mechanical neck pain and the identification of lateral flexion fixations in the cervical spine were made with conventional clinical evaluation, including motion palpation. Group A received a cervical rotary manipulation(s) on the ipsilateral side of the lateral flexion fixation(s), while group B received a supine lateral break manipulation(s) on the contralateral side of the lateral flexion fixation(s). Subjects received a maximum of 10 treatments over a 4-week treatment period.Outcome Measures: Both treatment groups were assessed with subjective (Numerical Pain Rating Scale 101, McGill Short-Form Pain Questionnaire and the Canadian Memorial Chiropractic College Neck Disability Index) and objective (cervical range of motion goniometer and algometer) measurement parameters at the initial consultation (before any treatment), the final consultation, and at a 1-month follow-up consultation. Statistical analysis was conducted at a 95% confidence level (α = .05) with the non-parametric 2-tailed Wilcoxon signed ranks test, the Mann-Whitney U test, and descriptive statistics. Two-tailed power analysis was conducted after the fact, where a confidence level of 80% (β = .20) was considered satisfactory.Results: Intragroup analysis indicated a significant difference between the initial consultation data and the final consultation data for the subjective data, indicating an effect. Analysis of the objective data did not reveal any significant difference. Intergroup analysis did not reveal any significant difference between the 2 groups when comparing the data of the initial consultation and the final consultation, indicating that both treatments had a similar or equal effect. Power analysis was not satisfactory for most data, indicating the possibility of many Type II errors.Conclusion and Recommendations: Statistically, the results suggested that both treatments had an effect but that neither group showed a benefit over the other. However, because of the unsatisfactory power of the study, conclusions are to be drawn with caution. Clinical significance supported the statistical outcomes where it was suggested that both treatments had an effect and that neither treatment had a greater effect. A larger sample size and the inclusion of a placebo group is recommended to reveal true treatment outcomes and trends.