Spine Mobilization vs Manipulation: Effects on Neck Pain

Several studies have found an association between cervical spinal mobilization (CSMob) and cervical spinal manipulation (CSM) on pain perception, disability, and satisfaction. However, choosing the proper technique continues to be a challenge for many practitioners. The purpose of this study was to clarify the discrepant evidence regarding the efficacy of a CSMob versus a CSM intervention as compared to a control group – hands-off, and patient education (PE) in isolation. 36 subjects with acute and non-specific mechanical neck pain were randomly assigned to one of 3 groups (CSMob, CSM, or control). Outcome measures using the Neck Disability Index (NDI), Numeric Pain Rate Scale (NPRS), and Global Rate of Change (GROC) were quantified at baseline, 5-minutes post, and 4 days post corresponding intervention. The CSM group showed significant increase in GROC (p= 0.025) compared to the CSMob and control groups (p= 0.472 and p=0.176 respectively) over time. There was a significant decrease in NPRS for the CSM and CSMob groups (p= 0.002 and p= <0.001) and a non-significant decrease in NPRS (p= 0.642) in the control group over time. Similarly, there was a significant decrease in NDI for the CSM and CSMob groups (p= <0.001 and p= <0.001) and a nonsignificant decrease in NDI (p= 0.084) in the control group over time. Our study findings suggest that skilled manual therapy interventions can be a viable and effective treatment option for reducing neck pain, disability, and perceived favorable change following a single session on subjects with acute, non-specific mechanical neck pain.