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

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.ObjectiveTo determine whether neck manipulation is more effective for neck pain than mobilization.DesignRandomized controlled trial with blind assessment of outcome.SettingPrimary care physiotherapy, chiropractic, and osteopathy clinics in Sydney, Australia.ParticipantsPatients (N=182) with nonspecific neck pain less than 3 months in duration and deemed suitable for treatment with manipulation by the treating practitioner.InterventionsParticipants 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 MeasureThe number of days taken to recover from the episode of neck pain.ResultsThe 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).ConclusionsNeck manipulation is not appreciably more effective than mobilization. The use of neck manipulation therefore cannot be justified on the basis of superior effectiveness.