Preventive Neck Manipulation ...Not beneficial!
Reference:Martel J, et al A randomised controlled trial of preventive spinal manipulation with and without a home exercise program for patients with chronic neck pain. BMC Musculoskelet Disord. 2011 Feb 8;12:41.
The Cochran database concludes that there is evidence to support that supervised exercises, with or without manual therapy, can be beneficial for patients with non-specific chronic neck pain.
However the question is, once the condition is resolved, is it valuable to continue with regular neck manipulations for “preventative” purposes?
This chiropractic study randomly allocated 91 patients with chronic neck pain into 3 groups.
Group 1: Control group: Met with the chiropractor once / two months to only discuss their condition
Group 2: Spinal manipulation 1x / month
Group 3: Spinal manipulation & exercises 1x / month
Result: After 10 months, there were no differences among the groups with respect to pain scores, cervical ROM, or disability scores.
Clinical Relevance: The results of this study do not support the philosophy that long-term “maintenance” spinal manipulations help improve recovery rates for individuals with chronic musculoskeletal neck pain.
Personal Comment: I have a personal rule about spinal manipulations, either it proves effective in 2-3 sessions or it doesn’t. I certainly do not continue to manipulate if a patient plateaus, my maximum number is 3 …not 30!!!
Posted on: July 05, 2011
Categories: Cervical Spine