Chinese manipulation for mechanical neck pain: a systematic review

Area of Science:

• Integrative Medicine
• Musculoskeletal Rehabilitation
• Evidence-Based Practice

Background:

• Neck pain is a prevalent condition affecting adults, with diverse treatment approaches.
• Chinese manipulation, a form of manual therapy, is utilized for various musculoskeletal ailments.
• The efficacy of Chinese manipulation for neck pain requires rigorous evaluation.

Purpose of the Study:

• To systematically review and synthesize evidence on the effectiveness of Chinese manipulation for adults with neck pain.
• To assess improvements in pain, function/disability, and global perceived effect.
• To evaluate the quality of evidence supporting Chinese manipulation for neck pain.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (CAJ, Wanfang, Cochrane, Medline).
• Keywords included 'manual therapy,' 'Chinese manipulation,' 'neck pain,' and 'randomized controlled trial.'
• Two independent reviewers selected studies, extracted data, assessed risk of bias, and analyzed results using meta-analysis, with evidence quality graded by GRADE.

Main Results:

• Four studies (610 participants) met the inclusion criteria.
• Very low-quality evidence suggests Chinese manipulation offers superior immediate pain relief and global symptom improvement compared to cervical traction.
• Chinese manipulation alone demonstrated greater immediate pain relief than traditional Chinese massage, based on very low-quality evidence.

Conclusions:

• Limited evidence indicates that Chinese manipulation may provide short-term benefits for neck pain.
• The current evidence base is of very low quality, restricting definitive conclusions.
• Further high-quality randomized controlled trials are needed to establish the efficacy and durability of Chinese manipulation for neck pain.