Effect of manual therapy and stretching on neck muscle strength and mobility in chronic neck pain

Neck pain is a frequent health problem. Manual therapy (MT) and transcutaneous electrical nerve stimulation (TENS) are recommended techniques for treatment of mechanical neck disorders (MND) in Spanish Public Primary Care Physiotherapy Services. The aim of this study was to compare the efficacy of MT versus TENS in active mobility and endurance in cervical subacute or chronic neck pain. Ninety patients with MND were randomly allocated to receive ten 30-min sessions of either MT or TENS, in a multi-centered study through 12 Primary Care Physiotherapy Units in the Madrid community. Active cervical range of motion (CD-ROM) and endurance (Palmer and Epler test) were evaluated pre- and post-intervention and at 6-month follow-up. A generalized linear model of repeated measures was constructed for the analysis of differences. Post-intervention MT yielded a significant improvement in active mobility and endurance in patients with subacute or chronic MND, and at 6-month follow-up the differences were only significant in endurance and in sagittal plane active mobility. In the TENS group, no significant improvement was detected. With regard to other variables, MT improved mobility and endurance more effectively than TENS at post-intervention and at 6-month follow-up in the sagittal plane. Only MT generated significant improvements in cervical mobility and endurance in the three movement planes.

Download Full-text

Fascial treatment versus manual therapy (HVLA) in patients with chronic neck pain: A randomized controlled trial

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-191731 ◽

2021 ◽

pp. 1-10

Author(s):

Katrin Brück ◽

Kirsten Jacobi ◽

Tobias Schmidt

Keyword(s):

Neck Pain ◽

Manual Therapy ◽

Repeated Measures ◽

Primary Outcome ◽

Controlled Trial ◽

Severity Of Illness ◽

Chronic Neck Pain ◽

Secondary Outcome ◽

Control Group ◽

Industrialized Nations

BACKGROUND: Chronic neck pain (CNP) is a common health problem in western industrialized nations. In recent years, the fascial tissue has attracted the attention of therapists, and a treatment of the fasciae promises to be a meaningful approach in the therapy of patients with CNP. OBJECTIVE: The aim of this study was to investigate the effectiveness of a fascial treatment (FT) compared to manual therapy (MT) and to no intervention (control group, CG) in patients with CNP. METHODS: Sixty participants with CNP were randomized into three groups. Primary outcome parameters were pain intensity as measured by the visual analogue scale (VAS), and severity of illness as measured by the Neck Pain and Disability Scale (NPAD). Secondary outcome parameter was the range of motion (ROM) of the cervical spine. RESULTS: Repeated measures t-tests demonstrated significant decreases with medium to large effect sizes for the FT (VAS: dR⁢M= 1.14; NPAD: dR⁢M= 0.51) and for the MT (VAS: dR⁢M= 1.15; NPAD: dR⁢M= 0.72). CONCLUSION: Our results confirmed the effectiveness of MT on pain and severity of illness in the treatment of patients suffering from CNP. Furthermore, the results demonstrated the effectiveness and clinical relevance of FT for this population.

Download Full-text

Does the Addition of Manual Therapy Approach to a Cervical Exercise Program Improve Clinical Outcomes for Patients with Chronic Neck Pain in Short- and Mid-Term? A Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17186601 ◽

2020 ◽

Vol 17 (18) ◽

pp. 6601 ◽

Cited By ~ 2

Author(s):

Jacobo Rodríguez-Sanz ◽

Miguel Malo-Urriés ◽

Jaime Corral-de-Toro ◽

Carlos López-de-Celis ◽

María Orosia Lucha-López ◽

...

Keyword(s):

Cervical Spine ◽

Neck Pain ◽

Manual Therapy ◽

Exercise Program ◽

Chronic Neck Pain ◽

Exercise Group ◽

Home Exercise ◽

Upper Cervical Spine ◽

Upper Cervical ◽

Cervical Spine Dysfunction

Chronic neck pain is one of today’s most prevalent pathologies. The International Classification of Diseases categorizes four subgroups based on patients’ associated symptoms. However, this classification does not encompass upper cervical spine dysfunction. The aim is to compare the short- and mid-term effectiveness of adding a manual therapy approach to a cervical exercise protocol in patients with chronic neck pain and upper cervical spine dysfunction. Fifty-eight subjects with chronic neck pain and upper cervical spine dysfunction were recruited (29 = Manual therapy + Exercise; 29 = Exercise). Each group received four 20-min sessions, one per week during four consecutive weeks, and a home exercise regime. Upper flexion and flexion-rotation test range of motion, neck disability index, craniocervical flexion test, visual analogue scale, pressure pain threshold, global rating of change scale, and adherence to self-treatment were assessed at the beginning, end of the intervention and at 3- and 6-month follow-ups. The Manual therapy + Exercise group statistically improved short- and medium-term in all variables compared to the Exercise group. Four 20-min sessions of Manual therapy + Exercise along with a home-exercise program is more effective in the short- to mid-term than an exercise protocol and a home-exercise program for patients with chronic neck pain and upper cervical dysfunction.

Download Full-text

Manual therapy versus therapeutic exercise in non-specific chronic neck pain: study protocol for a randomized controlled trial

Trials ◽

10.1186/s13063-019-3598-7 ◽

2019 ◽

Vol 20 (1) ◽

Author(s):

Carlos Bernal-Utrera ◽

Juan José González-Gerez ◽

Manuel Saavedra-Hernandez ◽

Miguel Ángel Lérida-Ortega ◽

Cleofás Rodríguez-Blanco

Keyword(s):

Randomized Controlled Trial ◽

Neck Pain ◽

Manual Therapy ◽

Study Protocol ◽

Controlled Trial ◽

Chronic Neck Pain ◽

Therapeutic Exercise ◽

Randomized Controlled

Download Full-text

Does Deep Cervical Flexor Muscle Training Affect Pain Pressure Thresholds of Myofascial Trigger Points in Patients with Chronic Neck Pain? A Prospective Randomized Controlled Trial

Rehabilitation Research and Practice ◽

10.1155/2016/6480826 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Pavlos Bobos ◽

Evdokia Billis ◽

Dimitra-Tania Papanikolaou ◽

Constantinos Koutsojannis ◽

Joy C. MacDermid

Keyword(s):

Neck Pain ◽

Pain Threshold ◽

Controlled Trial ◽

Neck Disability Index ◽

Chronic Neck Pain ◽

Trigger Points ◽

Neck Muscle ◽

Myofascial Trigger Points ◽

Neck Disability ◽

Over Time

Background. We need to understand more about how DNF performs in different contexts and whether it affects the pain threshold over myofascial trigger points (MTrPs). Purpose. The objectives were to investigate the effect of neck muscles training on disability and pain and on pain threshold over MTrPs in people with chronic neck pain. Methods. Patients with chronic neck pain were eligible for participation with a Neck Disability Index (NDI) score of over 5/50 and having at least one MTrP on either levator scapulae, upper trapezoid, or splenius capitis muscle. Patients were randomly assigned into either DNF training, superficial neck muscle exercise, or advice group. Generalized linear model (GLM) was used to detect differences in treatment groups over time. Results. Out of 67 participants, 60 (47 females, mean age: 39.45 ± 12.67) completed the study. Neck disability and neck pain were improved over time between and within groups (p<0.05). However, no differences were found within and between the therapeutic groups (p<0.05) in the tested muscles’ PPTs and in cervicothoracic angle over a 7-week period. Conclusion. All three groups improved over time. This infers that the pain pathways involved in the neck pain relief are not those involved in pain threshold.

Download Full-text