Today I’d like to share an article published by the Annals of Internal Medicine: “Spinal Manipulation, Medication, or Home Exercise With Advice for Acute and Subacute Neck Pain, A Randomized Trial.” This trial was a collaboration among medical doctors and chiropractors.
In this trial, 272 persons aged 18-65 were randomized to one of three intervention groups:
Spinal Manipulative Therapy (SMT) Group: Sessions lasted 15-20 minutes and included manual adjustment (high velocity joint thrust) and mobilization (low velocity joint oscillation) to involved areas of the spine (areas of segmental loss of mobility). Additional therapies included light soft-tissue massage, stretching and hot/cold packs.
Medication Group: Non-steroidal anti-inflammatory drugs, acetaminophen or both were given as the first line of therapy. For those who did not respond, narcotic medications were used. Muscle relaxants were also used.
Home Exercise with Advice (HEA) Group: Two 1-hour sessions were provided in which therapists instructed participants on simple self-mobilization exercises for the neck and shoulders. Participants were instructed to do 5-10 repetitions of each exercise 6-8 times per day.
Throughout the trial, participants rated their level of pain, disability, global improvement, satisfaction, general health status and any side effects. The study concluded that SMT was superior to medication for both the short and long term for pain as well as the other outcome measures for participants with acute or subacute neck pain. A few sessions of HEA produced similar positive outcomes. Of note, side effects were most frequent in the medication group (at 60% of participants) and were systemic in nature (mainly GI symptoms and drowsiness) compared to SMT (at 40%) and HEA (at 46%) which were primarily musculoskeletal (mainly muscle soreness).
So, what is the take home message here? If you have neck pain, see a chiropractor! A chiropractor is a spinal health expert. The purpose of chiropractic is to restore optimal function and mechanical balance in your body such that no one area is being over-worked. It also helps to restore optimal communication within the nervous system such that you can heal at your greatest potential. A chiropractor will examine the area of complaint (as well as related structures), provide a diagnosis and offer manual therapy and advice to treat the underlying problem so you may return to your normal activities that you love.
Neck pain is fairly prevalent, affecting an estimated 70% of people at some point in their lives. It can have a significant negative effect on quality of life. So why wait? See your chiropractor today!
Dr. Elisabeth Miron