Cervical manipulation versus thoracic or cervicothoracic manipulations for the management of neck pain. A systematic review and meta-analysis

Key Points

1. Cervical manipulations are not superior to cervicothoracic or thoracic manipulations for treating neck pain.

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BACKGROUND & OBJECTIVE

Neck pain (NP) is a very common musculoskeletal condition that healthcare clinicians will see. Clinical practice guidelines recommend physiotherapy as the first line of treatment for NP; however, choosing a particular intervention can be more of a challenge. Exercise and manual therapy are common choices for interventions; however, many factors impact the choice of interventions to help people with NP.

This systematic review and meta-analysis aimed to compare the effects of cervical thrust or non-thrust manipulations to thoracic or cervicothoracic manipulations for improving pain intensity, neck disability, and cervical range of motion (ROM) in patients with NP.

Clinical practice guidelines recommend physiotherapy as the first line of treatment for neck pain.

Choosing less risky cervicothoracic or thoracic manipulations is not less effective than cervical manipulations.

METHODS

• The protocol for this systematic review was pre-registered with PROSPERO, and followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) and Cochrane recommendations.

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