Spinal Manipulation as a Treatment for Neck Pain: A Systematic Review of Randomized Controlled Trials

Abstract

Abstract Background: Cervical pain is one of the most common pathologies in physiotherapy consultations. Currently, there are countless techniques, protocols, and treatments ranging from conservative to invasive. The intervention includes orthopedic manual therapy techniques in patients who present the pathology. To date, several studies apply spinal manipulation as a treatment option for patients with neck pain; however, its effects on pain and disability are unknown. Methodology: A compilation, selection, and analysis of randomized clinical trials was carried out, and studies showed the effect of this technique on the type and origin of pain in patients with neck pain. Data extraction was formulated in tables, and the methodological quality was determined through the physiotherapy evidence database scale. Results: Thirty studies were included that were classified based on the type and origin of pain. In order to determine the effectiveness, it was applied as the only treatment technique or as part of a multimodal treatment. Conclusions: Spinal manipulation has a greater effect on pain and disability when considered as the only treatment technique in patients with acute pain. However, when applied as part of the multimodal protocol, it proves to be effective in chronic, radicular, mechanical, and nonspecific pain. The high heterogeneity of the studies is a limitation of our findings.

Keywords

• spinal manipulation, neck pain, cervical vertebral, acute pain, chronic pain.