Manipulation, exercise reduce neck pain
MedWire news: Spinal manipulation therapy and a strategy of home exercise with instruction may both be more effective than medication at relieving acute and subacute neck pain, US researchers report.
"The performance of the home exercise with advice group, which has the potential for cost savings over both spinal manipulation therapy and medication interventions, is noteworthy," comment authors Dr Gert Bronfort and colleagues from Minneapolis Medical Research Foundation, Minnesota.
Among the 272 participating adults with nonspecific neck pain lasting 2-12 weeks, treatment with spinal manipulation for 12 weeks led to significantly greater improvements in the primary outcome of participant-rated pain (on a simple 0-10 scale of pain severity) than did medication for the same duration at 8, 12, 26 and 52 weeks of follow-up.
Home exercise with instructional sessions also improved self-rated pain significantly compared with medication, but only at 26 weeks after randomisation. However, there were no significant differences in the primary outcome between the spinal manipulation and home exercise interventions at any time point.
Researchers from Australia Dr Bruce Walker (Murdoch University, Western Australia) and Dr Simon French (University of Melbourne, Victoria) caution in a related editorial that none of the interventions was compared with placebo or sham therapy. Nor was there any reporting of adherence to the home exercise or medication, they add, which may have influenced the results.
Given the marginal differences in effectiveness they reason that GPs should consider patients' preferred approach - and emphasis that they must inform patients who wish to choose manipulation of the "rare but catastrophic risk for stroke".
MedWire News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012
By Caroline Price