Spinal Manipulation, Home Exercise May Ease Neck Pain

MONDAY, Jan. 2 (HealthDay News) — Spinal manipulation and home
exercise are more effective at relieving neck pain in the long term than
medications, according to new research.

People undergoing spinal manipulation therapy for neck pain also
reported greater satisfaction than people receiving medication or doing
home exercises.

“We found that there are some viable treatment options for neck pain,”
said Gert Bronfort, vice president of research at the Wolfe-Harris Center
for Clinical Studies at Northwestern Health Sciences University in
Bloomington, Minn.

“What we don’t really know yet is how to individualize these treatments
for each particular patient. All are probably still viable treatment
options, but what we don’t know is what each particular patient will
need,” Bronfort said, adding that it’s possible a combination of
treatments might be helpful, too.

Results of the study are published in the Jan. 3 issue of the Annals
of Internal Medicine
. Funding for the study was provided by the U.S.
National Center for Complementary and Alternative Medicine.

Neck pain is an extremely common problem. About three-quarters of
adults report having neck pain at some point in their lives, according to
background information in the study. Neck pain is responsible for millions
of health care visits each year, and it can have a negative impact on
quality of life.

Spinal manipulation is one type of treatment that’s offered for neck
pain, and it can be administered by chiropractors, physical therapists,
osteopaths and other health care providers, according to the study.

But, there isn’t much evidence for treating neck pain with spinal
manipulation. There also isn’t a great deal of information on how
effective medications or home exercise programs are for treating neck
pain, the researchers noted.

Bronfort and colleagues thought that spinal manipulation might prove to
be more effective than medications or home exercise therapy. To test
their hypothesis, they recruited 272 people between the ages of 18 and 65
who had neck pain. Their neck pain had no known cause, such as a trauma or
pinched nerve, and the patients been experiencing the pain for between two
and 12 weeks when the study began.

The study volunteers were randomly selected for one of three treatment
groups. One group received spinal manipulations over a 12-week period.
Each individual was allowed to choose the number of spinal manipulations
they felt they needed.

The second group received medications, both over the counter and
prescription, depending on their needs. First-line medications included
nonsteroidal anti-inflammatory medications or acetaminophen (Tylenol). If
people didn’t get relief from these drugs, narcotic pain medications and
muscle relaxants were offered.

The third group was assigned two one-hour sessions of home exercise.
The goal of the home-exercise program was to improve movement in the neck
area. Participants were instructed to do the exercises six to eight times
per day.

At the 12th week, 82 percent of people receiving spinal manipulation
reported at least a 50 percent reduction in pain, compared with 69 percent
of those on medication and 77 percent doing home exercises. Also at week
12, of people receiving spinal manipulation, 32 percent reported feeling a
100 percent reduction in pain, compared with 13 percent on medications and
30 percent doing home exercises.

At one year, 27 percent of those receiving spinal manipulation said
they felt a 100 percent reduction in pain versus 17 percent of those on
medications and 37 percent of those doing home exercises.

“For me, as an ER doctor, this study offers an interesting
perspective,” said Dr. Robert Glatter, an attending physician in emergency
medicine at Lenox Hill Hospital in New York City. “It’s a small study, but
it found that home exercises and spinal manipulation were effective. So,
should we be referring to physical therapists, osteopaths or chiropractors
from the ER?”

“This study shows that basically neck pain will get better on its own,”
said Dr. Victor Khabie, chief of the departments of surgery and sports
medicine at Northern Westchester Hospital in Mount Kisco, N.Y. “It
would’ve been good if they had a no-treatment group, too,” he added.

“Everyone heals differently. There are different pathways to healing,
and whether you feel you’re better off with chiropractic, home exercises
or medications, this study shows that all three are basically just as
effective. Whatever your pathway to healing, in about six to eight weeks,
you should start to feel better,” said Khabie.

He also noted that it’s important for anyone receiving spinal
manipulation to know that there are rare, but serious risks that can occur
with neck manipulations.

All three experts said anyone experiencing neck pain needs to have it
evaluated to make sure there isn’t a serious or correctable cause of the
pain. This is especially true if you’ve been in a car accident, or if you
have any neurological symptoms, such as repeatedly dropping things, or if
you have pain radiating down your arm.

More information

Learn more about neck pain, its causes and treatment from the U.S. National Library of Medicine.

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