Archives of Physical Medicine and Rehabilitation
Volume 91, Issue 9 , Pages 1313-1318, September 2010

A Randomized Controlled Trial Comparing Manipulation With Mobilization for Recent Onset Neck Pain

Presented to the Australian Physiotherapy Association, October 1, 2009, Sydney, Australia.

  • Andrew M. Leaver, PhD

      Affiliations

    • Faculty of Health Sciences, University of Sydney, Sydney, Australia
    • Corresponding Author InformationCorrespondence to Andrew M. Leaver, PhD, Faculty of Health Sciences, University of Sydney, 75 East St, Lidcombe, NSW, 2141 Australia
    • ,
  • Christopher G. Maher, PhD

      Affiliations

    • George Institute for Global Health, Sydney, Australia
    • ,
  • Robert D. Herbert, PhD

      Affiliations

    • George Institute for Global Health, Sydney, Australia
    • ,
  • Jane Latimer, PhD

      Affiliations

    • George Institute for Global Health, Sydney, Australia
    • ,
  • James H. McAuley, PhD

      Affiliations

    • Neuroscience Research Australia, Sydney, Australia
    • ,
  • Gwendolen Jull, PhD

      Affiliations

    • Division of Physiotherapy, University of Queensland, Brisbane, Australia
    • ,
  • Kathryn M. Refshauge, PhD

      Affiliations

    • Faculty of Health Sciences, University of Sydney, Sydney, Australia

Abstract 

Leaver AM, Maher CG, Herbert RD, Latimer J, McAuley JH, Jull G, Refshauge KM. A randomized controlled trial comparing manipulation with mobilization for recent onset neck pain.

Objective

To determine whether neck manipulation is more effective for neck pain than mobilization.

Design

Randomized controlled trial with blind assessment of outcome.

Setting

Primary care physiotherapy, chiropractic, and osteopathy clinics in Sydney, Australia.

Participants

Patients (N=182) with nonspecific neck pain less than 3 months in duration and deemed suitable for treatment with manipulation by the treating practitioner.

Interventions

Participants were randomly assigned to receive treatment with neck manipulation (n=91) or mobilization (n=91). Patients in both groups received 4 treatments over 2 weeks.

Main Outcome Measure

The number of days taken to recover from the episode of neck pain.

Results

The median number of days to recovery of pain was 47 in the manipulation group and 43 in the mobilization group. Participants treated with neck manipulation did not experience more rapid recovery than those treated with neck mobilization (hazard ratio=.98; 95% confidence interval, .66–1.46).

Conclusions

Neck manipulation is not appreciably more effective than mobilization. The use of neck manipulation therefore cannot be justified on the basis of superior effectiveness.

Key Words: Chiropractic, Manipulation, spinal, Neck pain, Rehabilitation

 

 Supported by the Australian National Health and Medical Research Council (grant no. 402686) and the University of Sydney.

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

 Trial Registration: Australian New Zealand Clinical Trials Registry, ACTRN12606000417583.

 Reprints are not available from the author.

PII: S0003-9993(10)00315-1

doi:10.1016/j.apmr.2010.06.006

Archives of Physical Medicine and Rehabilitation
Volume 91, Issue 9 , Pages 1313-1318, September 2010

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