Can Manipulation Give Me Neck Pain Relief?

Manipulation is a technique for treating neck conditions. It is often used by Osteopaths, Chiropractors and increasingly being used by Physical Therapists and Medical Doctors.

Neck manipulation has been considered an effective treatment for managing neck pain. However, clinical observation showed that neck manipulation was not effective for every patient. It helps to know the signs for identifying patients with neck pain who are likely to respond to neck manipulation.

Neck pain and related problems occur frequently in modern societies and have a considerable impact on individuals and the society. Manipulation is one of the manual techniques for treating mechanical neck pain. Although the pain relief effect of neck manipulation has been demonstrated in many studies, it was reported not to be particularly effective in others.

Some studies showing positive effects of neck manipulation might have included more patients with factors favoring manipulation, while others that failed to show the positive effect of neck manipulation might have included fewer patients with such factors.

In Manual Therapy 11 (2006) 306-315 “Predictors for the immediate responders to cervical manipulation in patients with neck pain”, the study was to identify the predictors for patients with neck pain who would respond immediately to the neck manipulation treatment.

Pain Relief with Manipulation of NeckPatients who were referred for treatment of their neck pain were had diagnoses of cervical spondylosis with or without cervical radiculopathy, herniated neck disc, myofascial pain syndromes and neck related headaches. Patients were not chosen if they had vertebral basilar insufficiency, progressive neurological deficits, severe osteoporosis, history of neck fracture or surgery, diagnoses of psychological disorders, systemic diseases, or other problems that were contraindications to cervical manipulation. All potential study participants were initially screened by their referred physicians.

The study identified six important predictors including the “score of the Neck Disability Index of less than 11.50”, “having bilateral involvement pattern” (both sides), “not performing sedentary work greater than 5 hours per day”, “feeling better while moving the neck”, “without feeling worse while extending the neck” (bending the head backward), and the “diagnosis of spondylosis without radiculopathy” for immediate responders to the neck manipulation treatment.

The odds for patients with the initial Neck Disability Index score less than 11.50 obtaining a successful neck manipulation treatment are 3.84 times the odds for those who score greater than 11.50. The odds of relief for a single neck manipulation for patients with bilateral involvement pattern were 4.40 times higher than for those without the bilateral pattern. Sedentary work greater than 5 h per day came as an adverse factor in patients who received the neck manipulation treatment. With regards to the movement related factors, feeling better while moving the neck and without feeling worse while extending the neck were significantly associated with better neck pain relief outcome.

Another significant factor that was positively associated with immediate neck pain relief to a single manipulation was “without feeling worse while extending the neck”. This means that patients who felt worse while extending the neck might not obtain immediate relief from the neck manipulation. The odds of obtaining relief from manipulation for patients with a diagnosis of spondylosis without radiculopathy were 7.22 times higher than for those who had other diagnoses.

There have been various factors associating with good prognosis for clinical course of neck pain, which included younger age, male gender, less pain, shorter duration of current episode, lower disability status at entry, not stressful work-related factors, and lower psychological stress.

This study also revealed that lower disability status at entry, i.e. lower score of the Neck Disability Index, and the work demands not requiring prolonged sedentary work were significant factors for predicting relief of neck pain using manipulation. However, age, gender, pain intensity, and duration of current episode, and psychological status did not show significant predictability.

Six predictors including 1) initial scores on Neck Disability Index less than 11.5, 2) having bilateral involvement pattern, 3) not performing sedentary work more than 5 hours a day, 4) feeling better while moving the neck, 5) without feeling worse while extending the neck and 6) the diagnosis of spondylosis without radiculopathy were identified to significantly predict relief for neck manipulation. The presence of four or more of these increased the probability of success with neck manipulation to 89%. Dramatic increases of the responded probabilities of successful neck manipulation were revealed by having 3 or more of these predictors.

These predictors may significantly enhance the descision to seek professional care for neck manipulation as an appropriate intervention for mechanical neck pain.

So, you can take our Neck Disability Index on this site and see if you have some of these 6 factors which can help determine if you will get pain relief from neck manipulation.