Active or passive treatment for neck-shoulder pain in occupational health care? A randomized controlled trial.
OBJECTIVE
To compare the effectiveness of thoracic manipulations with instructions for physiotherapeutic exercises for the treatment of neck pain in occupational health care.


METHODS
Seventy-five subjects aged 30-55 years from a random sample of 241 employees of the Finnish Broadcasting Company were randomly allocated to treatment in the form of four thoracic manipulations (n = 43), or instructions for physiotherapeutic exercises (n = 32). The subjects reported neck-shoulder pain on a structured pain questionnaire using a visual analogue scale (VAS, 0-10). Muscle tenderness and tender thoracic levels were evaluated by a blinded investigator (A.S.) at 6- and 12 month follow-ups.


RESULTS
A statistically significant difference was found in self-reported worst pain by VAS at the 12 month follow-up in favour of the thoracic manipulation group.


CONCLUSIONS
The natural course of the neck-shoulder pain in this study appears benign; pain was also reduced in the drop-out group. Both treatments were found effective at the 12 month follow-up. The effect of four manipulations was more favourable than the personal exercise program in treating the more intense phase of pain.
Savolainen
Aslak
A
Finnish Broadcasting Company, FIN-00025 Yleisradio, Helsinki, Finland.
Ahlberg
Jari
J
Nummila
Hanna
H
Nissinen
Maunu
M
D000328:Adult; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods; D019547:Neck Pain / Q000628:therapy*; D009784:Occupational Diseases / Q000628:therapy*; D009786:Occupational Health Services / Q000379:methods; D026741:Physical Therapy Modalities / Q000379:methods; D012782:Shoulder / Q000503:physiopathology; D013909:Thorax; D016896:Treatment Outcome