Specific and shared mechanisms associated with treatment for chronic neck pain: the SS-MECH mechanistic clinical trial

Key Points

1. Manual therapy and exercise produced similar changes in every mechanism the researchers measured, including neck mobility, pressure pain threshold, muscle endurance, self-efficacy, fear, coping, therapeutic alliance, and patient engagement.

All key points available for members only

Start free trial

Or log in here

BACKGROUND & OBJECTIVE

Manual therapy and exercise are both recommended as first-line treatments for chronic neck pain, and trials comparing them typically report similar clinical outcomes. However, it is unknown whether they work through similar or distinct mechanisms. It is typically assumed that manual therapy acts through improving tissue mobility or modulating pain, and that exercise works through improving strength and endurance.

This trial was designed as a mechanistic clinical trial, meaning its primary objective was not to establish whether the treatments are effective, but to determine whether they work through specific or shared mechanisms. Clinical outcomes were assessed as a secondary objective.

Manual therapy and exercise are both recommended as first-line treatments for chronic neck pain, however, it is unknown whether their effects are through similar or distinct mechanisms.

Based on this research, the choice between manual therapy and exercise for chronic neck pain can reasonably be based on patient preference, access, cost, and clinician skill.

METHODS

• The study recruited 129 adults with neck pain of at least 3/10 on most days for at least three months. Participants were excluded if they had red flags, suspected radicular symptoms, or neck surgery within the previous year. Participants were

Start free trial

to unlock full access to this review and 1313 more

Or log in here