Spinal Manipulative Therapy for Acute Neck Pain: A Systematic Review and Meta-Analysis of Randomised Controlled...

Area of Science:

• Orthopedics
• Physical Therapy
• Pain Management

Background:

• Acute neck pain is a prevalent condition often managed with medication or manual therapy.
• General practitioners express reservations regarding manual therapy's efficacy and potential adverse events.
• Uncertainty exists regarding the optimal treatment strategies for acute neck pain.

Purpose of the Study:

• To systematically review randomized controlled trials (RCTs) evaluating spinal manipulative therapy (SMT) for acute neck pain.
• To assess the effectiveness and safety of SMT in managing acute neck pain.
• To synthesize evidence from existing RCTs to inform clinical practice.

Main Methods:

• A systematic review of original randomized controlled trials (RCTs) was conducted.
• Data extraction was performed in duplicate and findings tabulated.
• Study quality was assessed using the Cochrane Back and Neck (CBN) Risk of Bias tool, and evidence graded using GRADE criteria.

Main Results:

• Six RCTs were included in the review.
• A significant pooled effect size (SMT vs. controls) of -1.37 indicated strong effectiveness for SMT in reducing neck pain.
• One study demonstrated SMT's superiority over ketorolac for acute neck pain relief one day post-treatment.

Conclusions:

• Spinal manipulative therapy (SMT), whether standalone or combined with other treatments, is effective for acute neck pain.
• Minor transient adverse events like increased pain and headache were reported, with no serious adverse events noted.
• Limitations include the small number and variable quality of studies, pragmatic designs, and high heterogeneity, necessitating further research.