title: Stretching exercises vs manual therapy in treatment of chronic neck pain: a randomized, controlled cross-over trial.
abstract: OBJECTIVE
  To compare the effects of manual therapy and stretching exercise on neck pain and disability.
  
  
  METHODS
  An examiner-blinded randomized cross-over trial.
  
  
  METHODS
  A total of 125 women with non-specific neck pain.
  
  
  METHODS
  PATIENTS were randomized into 2 groups. Group 1 received manual therapy twice weekly and Group 2 performed stretching exercises 5 times a week. After 4 weeks the treatments were changed. The follow-up times were after 4 and 12 weeks. Neck pain (visual analogue scale) and disability indices were measured.
  
  
  RESULTS
  Mean value (standard deviation) for neck pain was 50 mm (22) and 49 mm (19) at baseline in Group 1 and Group 2, respectively, and decreased during the first 4 weeks by 26 mm (95% Confidence Interval 20-33) and 19 mm (12-27), respectively. There was no significant difference between groups. Neck and shoulder pain and disability index decreased significantly more in Group 1 after manual therapy (p=0.01) as well as neck stiffness (p=0.01).
  
  
  CONCLUSIONS
  Both stretching exercise and manual therapy considerably decreased neck pain and disability in women with non-specific neck pain. The difference in effectiveness between the 2 treatments was minor. Low-cost stretching exercises can be recommended in the first instance as an appropriate therapy intervention to relieve pain, at least in the short-term.
authors.affiliation: Department of Physical and Rehabilitation Medicine, Jyväskylä Central Hospital, Keskussairaalantie 19, Jyväskylä, Finland. jari.ylinen@ksshp.fi
authors.forename: Jari
authors.initials: J
authors.lastname: Ylinen
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.forename: Kaija
authors.initials: K
authors.lastname: Wirén
authors.forename: Arja
authors.initials: A
authors.lastname: Häkkinen
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020393:Manipulation, Spinal / Q000379:methods*; D008875:Middle Aged; D052580:Muscle Stretching Exercises; D009334:Neck Muscles / Q000503:physiopathology; D019547:Neck Pain / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy*; D010147:Pain Measurement; D016896:Treatment Outcome