Hands-on therapy combined with exercise has benefits for neck pain

Exercise is considered an important part of treatment

When there is no specific cause that leads to the development of neck pain, it's referred to as nonspecific. Nonspecific neck pain is a very common condition that affects between 30-50% of the general population. This type of pain usually has a negative effect on daily life and can cause patients to seek out treatments that may become expensive over time. It is therefore important that the treatment these patients receive is effective and improves their physical functioning and quality of life. Exercise is one intervention that is strongly supported by research and considered an important part of any rehabilitation program. In particular, exercises that strengthen, or stabilize certain parts of the spine can be helpful for neck pain. In addition, a hands-on form of therapy called manual therapy may also be useful for reducing pain and increasing flexibility and function. Manual therapy includes two different approaches called manipulation and mobilization, and research has shown that these therapies can improve neck pain. On the other hand, there is a lack of studies that have looked into the combination of manual therapy and stabilization exercises for nonspecific neck pain. For this reason, a study called a randomized-controlled trial (RCT) was conducted. An RCT is a powerful, high-quality study that randomly assigns patients to different treatment groups in order to determine which of these treatments is more effective for neck pain.

Over 100 patients accepted and completed the study

Patients diagnosed with nonspecific neck pain for at least three months were recruited and screened to determine if they were eligible for this RCT. Out of the 116 patients assessed, 102 fit the necessary criteria and completed the study. Each patient was randomly assigned to one of two groups: the stabilization exercises only group or the manual therapy with stabilization exercises group. Patients in the stabilization exercises only group went through a program of three exercise sessions per week for four weeks. Each session lasted one hour and consisted of exercises that were intended to strengthen and stabilize the muscles surrounding the neck and shoulder blades. Before each session, the physical therapist would also provide education on how to achieve and maintain proper posture to reduce strain on the neck. Patients in the other group received the same treatments, as well as a series of mobilizations to the neck and shoulder blade region. These applications lasted for 15-20 minutes and were also performed three times a week for four weeks. All patients were evaluated for disability, neck pain intensity, quality of life and neck range of motion, or flexibility, before and immediately after the treatments.

Combining the two treatments leads to the greatest benefits

After four weeks, it was found that stabilization exercises and manual therapy led to greater improvements in disability, pain intensity at night, neck range of motion and quality of life than stabilization exercises only. This shows that while stabilization exercises may be beneficial on their own, combining them with manual therapy appears to lead to even better results. Since this RCT only evaluated these patients before the treatments and after they concluded four weeks later, it's difficult to determine if these treatments will also lead to long-term benefits. Additional studies are needed to investigate this matter in greater detail. Nonetheless, this RCT supports the use of stabilization exercises and manual therapy for treating nonspecific neck pain, and patients with this condition are encouraged to seek out physical therapy that can deliver these effective treatments in order to help them improve.

-As reported in the February '16 issue of the Journal of Orthopaedic & Sports Physical Therapy
May 25, 2017