Effectiveness of Manipulative Therapy on Neck Pain, Function and Disability. A Systematic Review

Background: Neck pain is a common musculoskeletal issue affecting people worldwide, and manipulative therapy is implemented as a treatment for it. Aim: To analyse the effects of different manipulative therapy techniques on the pain intensity, sensitivity and function in patients with neck pain. Methods. Studies between 2012 - April 2022 were selected to investigate the effectiveness of manipulative therapy on neck pain, function and disability. The databases PubMed ®, CNKI, Science Direct, Springer LINK, ResearchGate, Semantic Scholar, Taylor & Francis Online and Google Scholar were utilised. The selection criteria included studies involving human subjects with neck musculoskeletal pain, focusing on the effects of manipulative therapy on neck pain management and function. Results: 10 studies with 573 subjects were included. Strong evidence supported that manipulative therapy was effective in reducing pain and increasing the pain threshold and the function of the neck. A significant (p<0.05) positive effect was reported by 100% of studies that implemented the above parameters. Moderate evidence showed that manipulative therapy was effective in the management of the disability of the neck. The ratio of positive effect was 66.66% among involved studies with very significant results (p<0.01). Moderate evidence with a limited amount of study showed a significant increase in muscle strength after manipulative therapy (p<0.05). Conclusions. Manipulative therapy is effective in reducing neck pain intensity and sensitivity as well as improving neck function and reducing disability. The combined application of manipulative therapy is always more effective than the isolated application of manipulative therapy on patients with neck pain. Keywords: Neck pain; manipulative therapy; effectiveness; pain threshold; pain intensity; neck function