title: Systematic review of manual therapies for nonspecific neck pain.
abstract: OBJECTIVE
  To evaluate the effectiveness of manual therapies in the treatment of nonspecific neck pain.
  
  
  METHODS
  Medline and the Cochrane Library were searched for randomized controlled trials of manual therapy or mobilization, used alone or with exercises to treat pain and functional impairment related to nonspecific neck pain. Cochrane Back Review Group criteria were used to assess the quality of the trials and the level of evidence (unclear, limited, moderate, or high) for short-, medium-, and long-term effects.
  
  
  RESULTS
  Of 27 identified trials, 18 were of high quality. In acute neck pain, effective treatments were thoracic manipulation combined with electrothermal therapy in the short term and cervical manipulation in the long term. In chronic neck pain and neck pain of variable duration, both pain and function improved consistently at all follow-up time points. None of the manual therapies used alone or in combination was superior over the others. In the long term, exercises alone or combined with manual therapies were superior over manual therapies used alone.
  
  
  CONCLUSIONS
  Manual therapies contribute usefully to the management of nonspecific neck pain. The level of evidence is moderate for short-term effects of upper thoracic manipulation in acute neck pain, limited for long-term effects of neck manipulation, and limited for all techniques and follow-up durations in chronic neck pain.
authors.affiliation: Société franco-européenne de chiropratique (SOFEC), 25, avenue du Raincy, 93250 Villemomble, France.
authors.forename: Karl
authors.initials: K
authors.lastname: Vincent
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Maigne
authors.forename: Cyril
authors.initials: C
authors.lastname: Fischhoff
authors.forename: Olivier
authors.initials: O
authors.lastname: Lanlo
authors.forename: Simon
authors.initials: S
authors.lastname: Dagenais
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D059350:Chronic Pain; D006801:Humans; D008875:Middle Aged; D026201:Musculoskeletal Manipulations; D019547:Neck Pain / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D055815:Young Adult