Annals of Internal Medicine published the results of a randomized controlled trial comparing Manual Therapy, Physical Therapy, or Continued Care by a General Practitioner for Patients with Neck Pain in 2002:
Neck pain is a common problem in the general population, with point prevalences between 10% and 15% (1–3). It is most common at approximately 50 years of age and is more common in women than in men (1, 2, 4–6). Neck pain can be severely disabling and costly, and little is known about its clinical course (7–9). Limited range of motion and a subjective feeling of stiffness may accompany neck pain, which is often precipitated or aggravated by neck movements or sustained neck postures. Headache, brachialgia, dizziness, and other signs and symptoms may also be present in combination with neck pain (10, 11). Although history taking and diagnostic examination can suggest a potential cause, in most cases the pathologic basis for neck pain is unclear and the pain is labeled nonspecific. Conservative treatment methods that are frequently used in general practice include analgesics, rest, or referral to a physical therapist or manual therapist (12, 13). Physical therapy may include passive treatment, such as
massage, interferential current, or heat applications, and active treatment, such as exercise therapies. . .
Results: At 7 weeks, the success rates were 68.3% for manual therapy, 50.8% for physical therapy, and 35.9% for continued care. Statistically significant differences in pain intensity with manual therapy compared with continued care or physical therapy ranged from 0.9 to 1.5 on a scale of 0 to 10. Disability scores also favored manual therapy, but the differences among groups were small. Manual therapy scored consistently better than the other two interventions on most outcome measures. Physical therapy scored better than continued care on some outcome measures, but the differences were not statistically significant.
Conclusion: In daily practice, manual therapy is a favorable treatment option for patients with neck pain compared with physical therapy or continued care by a general practitioner.
Find the entire paper at http://www.annals.org
Ann Intern Med. 2002;136:713-722.