A randomized controlled trial comparing manipulation with mobilization for recent onset neck pain.
A randomized controlled trial comparing manipulation with mobilization for recent onset neck pain.


OBJECTIVE
To determine whether neck manipulation is more effective for neck pain than mobilization.


METHODS
Randomized controlled trial with blind assessment of outcome.


METHODS
Primary care physiotherapy, chiropractic, and osteopathy clinics in Sydney, Australia.


METHODS
Patients (N=182) with nonspecific neck pain less than 3 months in duration and deemed suitable for treatment with manipulation by the treating practitioner.


METHODS
Participants were randomly assigned to receive treatment with neck manipulation (n=91) or mobilization (n=91). Patients in both groups received 4 treatments over 2 weeks.


METHODS
The number of days taken to recover from the episode of neck pain.


RESULTS
The median number of days to recovery of pain was 47 in the manipulation group and 43 in the mobilization group. Participants treated with neck manipulation did not experience more rapid recovery than those treated with neck mobilization (hazard ratio=.98; 95% confidence interval, .66-1.46).


CONCLUSIONS
Neck manipulation is not appreciably more effective than mobilization. The use of neck manipulation therefore cannot be justified on the basis of superior effectiveness.
Leaver
Andrew M
AM
University of Sydney, Sydney, Australia. leaver@sydney.edu.au
Maher
Christopher G
CG
Herbert
Robert D
RD
Latimer
Jane
J
McAuley
James H
JH
Jull
Gwendolen
G
Refshauge
Kathryn M
KM
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D026882:Manipulation, Chiropractic / Q000009:adverse effects; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000009:adverse effects / Q000379:methods*; D019547:Neck Pain / Q000534:rehabilitation*; D016016:Proportional Hazards Models; D020127:Recovery of Function; D016037:Single-Blind Method; D013997:Time Factors