“Short- and mid-term effects of adding upper cervical manual therapy to a conventional physical therapy program in patients with chronic mechanical neck pain. Randomized controlled clinical trial.”

Abstract

Objective: To evaluate the effect of adding an Upper Cervical Translatoric Mobilization (UCTM) or an Inhibitory Suboccipital Technique (IST) to a physiotherapy treatment in the symptomatology and function of mechanical chronic neck pain patients. Design: Randomized controlled trial. Setting: Primary Care Center in Cornellà, Spain. Subjects: 78 patients (64 women), with mean age (SD) of 59.96 (13.30) years with mechanical chronic neck pain were divided in three groups: control, IST and UCTM groups. Interventions: All groups received 15 physiotherapy sessions for three weeks. The UCTM and IST groups added 5 minutes of the assigned technique during six sessions. Main measures: Neck disability index (NDI) and numeric pain rating scale (NPRS) for neck pain were measured baseline, three-weeks and 15-weeks follow-up. Results: NDI (SD) at baseline, three-weeks and 15-weeks were 11.62 (7.08), 9.65 (6.25), 7.58 (5.64) for the control group, 14.38 (6.92), 8.50 (6.11), 7.12 (4.98) for the IST group and 13.19(7.23), 5.35(6.10), 4.35(2.76) for the UCTM group. NPRS (SD) at baseline, three-weeks and 15-weeks were 58.69 (19.46), 45.19 (23.43), 44.58 (24.08) for the control group; 64.08 (19.26), 42.19 (19.69), 34 (21.14) for the IST group; and 67.65 (20.65), 36.23 (20.10), 39.85 (25.44) for the UCTM group. Conclusions: Compared with no treatment, both forms of mobilization were associated with reduced disability at three weeks, and UCTM remained better than control at 15 weeks; there were no significant differences between the two mobilization groups. Trial registration: This study was registered in Clinicaltrials.gov (NCT02832232).

Comparison of an exercise program with and without manual therapy for patients with chronic neck pain and upper cervical rotation restriction. Randomized controlled trial

“…Lack of mobility and symptoms arising from upper cervical spine are considered to be the main indication for upper cervical manual therapy approach ( Kaltenborn, 2012 ; Hidalgo García et al, 2016 ; Malo-Urriés et al, 2017 ; González-Rueda et al, 2021 ; Rodríguez-Sanz et al, 2021 ).…”

Benefits and Harms of Spinal Manipulative Therapy for Treating Recent and Persistent Nonspecific Neck Pain: A Systematic Review With Meta-analysis

“…4,46,61,115 The remaining 22 trials (78.6%; n = 22/28) were at "high risk" of bias for all the investigated outcomes (FIGURE 2). 2,10,24,35,36,39,42,[48][49][50][51]64,68,71,75,85,86,88,[95][96][97][98]…”

“…Cervical SMT vs CPG-recommended interventions Seventeen trials (19 comparisons) compared the effects on pain at short term 2,4,24,35,39,41,42,[49][50][51]64,71,86,[95][96][97][98] with a statistically significant effect favoring cervical SMT (SMD, 0.66; 95% CI: 0.97, 0.35; I 2 = 83%; very low evidence certainty) and 9 trials (10 comparisons) at long term 2,24,35,39,42,51,85,86,96 with a statistically significant effect favoring cervical SMT (SMD, 0.73; 95% CI: 1.16, 0.31; I 2 = 85%; very low evidence certainty) (FIGURE 3). Data could not be retrieved from 3 trials.…”

“…Data could not be retrieved from 1 trial. 85 Two trials (2 comparisons) found no difference on ROM at short term 48,95 SMT vs CPG Nonrecommended Interventions Two trials (2 comparisons) found no difference on pain at short term 49,95 (SMD, 0.25; 95% CI: 0.65, −0.14; I 2 = 0%; low evidence certainty) and one (1 comparison) at long term 49 (visual analog scale: MD, 5.9; 95% CI: −7.35, 19.15; very low evidence certainty) (FIGURE 4). [ literature review ] 94%; very low evidence certainty), and 2 trials (3 comparisons) at long term 61,68 (SMD, 0; 95% CI: −0.26, 0.26; I 2 = 0%; moderate evidence certainty).…”

Are there differences between a real C0-C1 mobilization and a sham technique in function and pressure pain threshold in patients with chronic neck pain and upper cervical restriction? A randomised controlled clinical trial

“…Different studies have shown that applying a C0-C1 mobilization treatment versus a control/sham group or adding it to a standardized physiotherapy treatment generates benefits in patients with chronic neck pain and upper cervical rotation restriction in pain and range of motion [9,[14][15][16][17][18]. Also, increasing upper cervical mobility is associated with the improvement of deep muscle recruitment, since there is a linear relationship between the range of motion of the upper cervical spine and the contractile capacity of the deep cervical musculature [19].…”