Manipulation and mobilisation for mechanical neck disorders

Area of Science:

• Orthopedics
• Physical Therapy
• Evidence-Based Medicine

Background:

• Mechanical neck disorders (MND) are prevalent, causing disability and significant healthcare costs.
• The efficacy of manual therapies like manipulation and mobilization for MND remains uncertain.

Purpose of the Study:

• To evaluate the effectiveness of manipulation and mobilization, alone or combined with other treatments, for pain relief, functional improvement, and patient satisfaction in adults with MND.
• To synthesize evidence from randomized controlled trials (RCTs) on manual therapies for mechanical neck disorders.

Main Methods:

• A systematic review and meta-analysis of randomized and quasi-randomized controlled trials were conducted.
• Searches of multiple databases (CENTRAL, MEDLINE, EMBASE, etc.) were performed up to March 2002.
• Data were extracted and analyzed using random-effects models to calculate pooled effect sizes.

Main Results:

• Manipulation or mobilization alone did not demonstrate significant pain relief for acute, subacute, or chronic MND.
• Multimodal care, combining mobilization/manipulation with exercise, showed strong evidence of benefit for pain reduction and functional improvement in subacute/chronic MND.
• Moderate evidence indicated no significant difference when multimodal care was compared to other treatments.

Conclusions:

• Multimodal care incorporating mobilization/manipulation and exercise provides sustained short-term and long-term benefits for subacute/chronic MND.
• Manual therapies alone or with other physical agents were not superior to each other or other treatments.
• Further research is needed to explore the role of exercise and identify optimal treatment characteristics for MND.