Spinal Manipulation Best for Neck Pain

 
December 27, 2012

By 

Approximately 70% of us will experience neck pain at some point in our lives, many of us more than once. While some people will be tempted to take a drug to relieve their pain, recent research demonstrates that this is the wrong choice.

The study compared spinal manipulation (SMT), medication and “home exercise with advice” (HEA) for acute and subacute neck pain in both the short and long periods. The researchers then measured the pain after 2, 4, 8, 12, 26, and 52 weeks.  What they found is that “SMT had a statistically significant advantage over medication after 8, 12, 26, and 52 weeks, and HEA was superior to medication at 26 weeks.” They further concluded that “for participants with acute and subacute neck pain, SMT was more effective than medication in both the short and long term.”

This is important to know. Safe, effective spinal manipulation can provide better relief from neck pain without the potentially dangerous side effects inherent in most drugs. As the study points out, the benefits may require 8 or more weeks depending on the cause of the pain. If you or someone you know has neck pain, direct them to a doctor of chiropractic who can get to the cause rather than risk masking the pain with drugs.

Original Research | 3 January 2012

Spinal Manipulation, Medication, or Home Exercise With Advice for Acute and Subacute Neck Pain: A Randomized Trial FREE

Gert Bronfort, DC, PhD; Roni Evans, DC, MS; Alfred V. Anderson, DC, MD; Kenneth H. Svendsen, MS; Yiscah Bracha, MS; and Richard H. Grimm, MD, MPH, PhD

Abstract

Background: Mechanical neck pain is a common condition that affects an estimated 70% of persons at some point in their lives. Little research exists to guide the choice of therapy for acute and subacute neck pain.

Objective: To determine the relative efficacy of spinal manipulation therapy (SMT), medication, and home exercise with advice (HEA) for acute and subacute neck pain in both the short and long term.

Design: Randomized, controlled trial. (ClinicalTrials.gov registration number: NCT00029770)

Setting: 1 university research center and 1 pain management clinic in Minnesota.

Participants: 272 persons aged 18 to 65 years who had nonspecific neck pain for 2 to 12 weeks.

Intervention: 12 weeks of SMT, medication, or HEA.

Measurements: The primary outcome was participant-rated pain, measured at 2, 4, 8, 12, 26, and 52 weeks after randomization. Secondary measures were self-reported disability, global improvement, medication use, satisfaction, general health status (Short Form-36 Health Survey physical and mental health scales), and adverse events. Blinded evaluation of neck motion was performed at 4 and 12 weeks.

Results: For pain, SMT had a statistically significant advantage over medication after 8, 12, 26, and 52 weeks (P ≤ 0.010), and HEA was superior to medication at 26 weeks (P = 0.02). No important differences in pain were found between SMT and HEA at any time point. Results for most of the secondary outcomes were similar to those of the primary outcome.

Limitations: Participants and providers could not be blinded. No specific criteria for defining clinically important group differences were prespecified or available from the literature.

Conclusion: For participants with acute and subacute neck pain, SMT was more effective than medication in both the short and long term. However, a few instructional sessions of HEA resulted in similar outcomes at most time points.

Primary Funding Source: National Center for Complementary and Alternative Medicine, National Institutes of Health.

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