Benefits and harms of spinal manipulative therapy for treating recent and persistent nonspecific neck pain: a systematic review with meta-analysis

Review written by Dr Jarod Hall info

Key Points

  1. Neck pain is a highly prevalent musculoskeletal condition that ranks as the fourth most common contributor to years lived with disability.
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BACKGROUND & OBJECTIVE

Neck pain is one of the most common and disabling musculoskeletal conditions, being the fourth global contributor to Years Lived with Disability with a global prevalence of 288.7 million cases (1,2,3). At present, there are many different clinical practice guidelines (CPGs) which provide contradictory recommendations for how to manage neck pain leading to confusion between healthcare providers and patients alike. Despite the variation in recommendations, it is currently agreed upon that the implementation of CPGs may hold promise for managing neck pain well.

Cervical spinal manipulative therapy (SMT) continues to be a common intervention for neck pain. Overall, the effectiveness of cervical SMT for reducing pain and disability varies between studies and their results appear to be dependent on symptom staging, outcomes, comparators, equipoise, and whether it is combined with other interventions.

No recent systematic reviews (SRs) have compared cervical SMT to CPG- recommended interventions for treating neck pain. The primary objective of this study was to examine the effectiveness of cervical SMT compared with CPG-recommended and CPG-not-recommended interventions for the outcomes of pain, disability, range of motion (ROM), and health-related quality of life (HRQoL) in adults with recent and persistent neck pain. The secondary objective was to examine the effectiveness of cervical SMT compared with sham cervical SMT or no intervention.

Neck pain is one of the most common and disabling musculoskeletal conditions, being the fourth global contributor to Years Lived with Disability with a global prevalence of 288.7 million cases.
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It is very likely spinal manipulative therapy may trigger placebo effects/meaning response which may impact the overall therapeutic outcome for patients.

METHODS

  • The authors’ search strategy identified a total of 12,379 potential studies, with 6,944 remaining following de-duplication.
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