Comparative Study of Hands-On Therapy With Active Exercises vs Education With Active Exercises for the Management of Upper Back Pain

ObjectiveThe aim of this study was to compare hands-on therapy, including heat, massage, and active exercises with postural education that emphasized increased self-efficacy and postural self-awareness along with education about the physiology of the disorder, and prescribed daily active exercises.SubjectsTwenty-four randomly selected women, 12 custodians and 12 students, with neck and shoulder pain and stiffness.MethodsAll subjects received a medical examination and x-ray before the study to rule out any pre-existing neurologic deficits and an evaluation that included history taking and self-reporting of pain according to a numeric pain scale. Student participants received education and exercise instructions to be continued daily. The custodial workers received once-per-week hands-on treatment.ResultsData were compared using a nonparametric analysis (Wilcoxon signed rank test) and showed evidence of statistically significant reductions in neck, shoulder, and back stiffness and shoulder muscle tension for most of the study subjects.ConclusionTreatment of repetitive stress injuries that combines maintenance of daily active exercises prescribed and modeled by a professional therapist, which emphasize postural awareness to correct poor posture and provide a basic physiological understanding of the disorder, is as crucial to reducing upper back and neck pain and stiffness as hands-on therapy with active exercise provided in a clinical setting.