Dr. Kyle: Manipulation and Mobilization for Neck Pain

An estimated 66% of the population will suffer from neck pain in their lifetime (1). Neck pain is one of the most common musculoskeletal conditions treated by healthcare professionals. Often patients will report pain due to sleeping awkwardly, turning their head too fast, or reaching for something overhead. Whatever the mechanism, neck pain accounts for a significant proportion of sick leave, healthcare costs and lost productivity. Chiropractors have been at the forefront of treating neck pain for decades, and the results speak for themselves.

What does the evidence suggest?

Previous systematic reviews on chronic mechanical neck pain have provided substantial evidence for the effectiveness of chiropractic care. Both spinal manipulation and mobilization have been shown to be a viable option of care as compared to other standard treatment methods (2).

A recent systematic review by Coulter et. al. compared spinal manipulation and mobilization to other active modalities such as acupuncture, massage, and exercise to name a few (3). The study looked at patient outcomes such as pain, disability and health related quality of life (HRQol). They found that many previous reviews regarding non-specific neck pain reported evidence in favor of manipulation and mobilization. Other reviews concluded that manual therapies in conjunction with exercise provided superior results as compared to manual therapy alone (4).

As with many musculoskeletal conditions, it appears that a multi-modal approach is best. At this point in time, there is moderate evidence to support manipulation and mobilization for the treatment of chronic nonspecific neck pain in terms of pain and function. It appears that some movement and active rehabilitation is better for patient recovery then complete rest. More studies are still required to look at the benefits of chiropractic manual therapies long term.

To some, these conclusions may not be overwhelming, but research like this is what continues to carry the chiropractic profession in a positive direction. It is exciting to know that chiropractors and researchers alike are looking into the efficacy and safety of chiropractic care so we can better treat our patients and our community.

If you or someone you love is suffering with lingering neck pain, it may be time to schedule a comprehensive chiropractic exam to get to the root of the problem. As always, if you have any questions please do not hesitate to contact me at drkyle@forwardhealth.ca or visit my professional Instagram page @drkylearam.

References:

1. Cote P, Cassidy JD, Carroll L; The Saskatchewan Health and Back Pain Survey. The prevalence of neck pain and related disability in Saskatchewan adults. Spine (Phila Pa 1976) 1998; 23:1689-1698

2. Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: A systematic review and best evidence synthesis. Spine J 2004; 4:335-356.

3. Herman, P. M. (2019). Manipulation and Mobilization for Treating Chronic Nonspecific Neck Pain: A Systematic Review and Meta-Analysis for an Appropriateness Panel. Pain Physician, 22, E55-E70.

4. Brison RJ, Hartling L, Dostaler S, LegerA, Rowe BH, Stiell I, Pickett W. A randomized controlled trial of an educational intervention to prevent the chronic pain of whiplash associated disorders following rear-end motor vehicle collisions. Spine 2005; 30:1799-1807.