Manual therapy with or without physical medicine modalities for neck pain: a systematic review.
Manual therapy interventions are often used with or without physical medicine modalities to treat neck pain. This review assessed the effect of 1) manipulation and mobilisation, 2) manipulation, mobilisation and soft tissue work, and 3) manual therapy with physical medicine modalities on pain, function, patient satisfaction, quality of life (QoL), and global perceived effect (GPE) in adults with neck pain. A computerised search for randomised trials was performed up to July 2009. Two or more authors independently selected studies, abstracted data, and assessed methodological quality. Pooled relative risk (RR) and standardised mean differences (SMD) were calculated when possible. We included 19 trials, 37% of which had a low risk of bias. Moderate quality evidence (1 trial, 221 participants) suggested mobilisation, manipulation and soft tissue techniques decrease pain and improved satisfaction when compared to short wave diathermy, and that this treatment combination paired with advice and exercise produces greater improvements in GPE and satisfaction than advice and exercise alone for acute neck pain. Low quality evidence suggests a clinically important benefit favouring mobilisation and manipulation in pain relief [1 meta-analysis, 112 participants: SMD -0.34(95% CI: -0.71, 0.03), improved function and GPE (1 trial, 94 participants) for participants with chronic cervicogenic headache when compared to a control at intermediate and long term follow-up; but no difference when used with various physical medicine modalities.
D'Sylva
Jonathan
J
School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, Ontario L8S 1C7, Canada.
Miller
Jordan
J
Gross
Anita
A
Burnie
Stephen J
SJ
Goldsmith
Charles H
CH
Graham
Nadine
N
Haines
Ted
T
Brønfort
Gert
G
Hoving
Jan L
JL
D000328:Adult; D006801:Humans; D026201:Musculoskeletal Manipulations / Q000379:methods*; D019547:Neck Pain / Q000534:rehabilitation*; D010147:Pain Measurement; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function