Manual therapy and exercise for neck pain: A systematic review
Abstract
Manual therapy is often used with exercise to treat neck pain. This cervical overview group systematic review update assesses if manual therapy, including manipulation or mobilisation, combined with exercise improves pain, function/disability, quality of life, global perceived effect, and patient satisfaction for adults with neck pain with or without cervicogenic headache or radiculopathy. Computerized searches were performed to July 2009. Two or more authors independently selected studies, abstracted data, and assessed methodological quality. Pooled relative risk (pRR) and standardized mean differences (pSMD) were calculated. Of 17 randomized controlled trials included, 29% had a low risk of bias. Low quality evidence suggests clinically important long-term improvements in pain (pSMD-0.87(95% CI: -1.69, -0.06)), function/disability, and global perceived effect when manual therapy and exercise are compared to no treatment. High quality evidence suggests greater short-term pain relief [pSMD-0.50(95% CI: -0.76, -0.24)] than exercise alone, but no long-term differences across multiple outcomes for (sub)acute/chronic neck pain with or without cervicogenic headache. Moderate quality evidence supports this treatment combination for pain reduction and improved quality of life over manual therapy alone for chronic neck pain; and suggests greater short-term pain reduction when compared to traditional care for acute whiplash. Evidence regarding radiculopathy was sparse. Specific resear…
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Other systematic reviews have shown similar results.
“Other systematic reviews have shown similar results.24”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [24]
Cites
Assessing the quality of reports of randomized clinical trials: Is blinding necessary?
Jadad, A. R., Moore, R. A., Carroll, D., Jenkinson, C., Reynolds, D. J. M., Gavaghan, D. J., & McQuay, H. J. (1996) · Controlled Clinical Trials · doi:10.1016/0197-2456(95)00134-4 · Cited by 17,582 · see citing works
Farrar, J. T., Young, J. P., LaMoreaux, L., Werth, J. L., & Poole, M. R. (2001) · Pain · doi:10.1016/s0304-3959(01)00349-9 · Cited by 5,808 · see citing works
Exercises for mechanical neck disorders
Gross, A., Kay, T. M., Paquin, J.-P., Blanchette, S., Lalonde, P., Christie, T., Dupont, G., Graham, N., Burnie, S. J., Gelley, G., et al. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004250.pub5 · Cited by 613 · see citing works
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Exercises for mechanical neck disorders
Gross, A., Kay, T. M., Paquin, J.-P., Blanchette, S., Lalonde, P., Christie, T., Dupont, G., Graham, N., Burnie, S. J., Gelley, G., et al. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004250.pub5 · Cited by 613 · see citing works
Self-citationArmijo-Olivo, S., Pitance, L., Singh, V., Neto, F., Thie, N., & Michelotti, A. (2016) · Physical Therapy · doi:10.2522/ptj.20140548 · Cited by 413 · see citing works
Llamas-Ramos, R., Pecos-Martín, D., Gallego-Izquierdo, T., Llamas-Ramos, I., Plaza-Manzano, G., Ortega-Santiago, R., Cleland, J., & Fernández-de-las-Peñas, C. (2014) · Journal of Orthopaedic & Sports Physical Therapy · doi:10.2519/jospt.2014.5229 · Cited by 185 · see citing works
Chronic Neck Pain and Exercise Interventions: Frequency, Intensity, Time, and Type Principle
O'Riordan, C., Clifford, A., Van De Ven, P., & Nelson, J. (2014) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2013.11.015 · Cited by 153 · see citing works
Beltran-Alacreu, H., López-de-Uralde-Villanueva, I., Fernández-Carnero, J., & La Touche, R. (2015) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0000000000000293 · Cited by 107 · see citing works
Campa-Moran, I., Rey-Gudin, E., Fernández-Carnero, J., Paris-Alemany, A., Gil-Martinez, A., Lerma Lara, S., Prieto-Baquero, A., Alonso-Perez, J. L., & La Touche, R. (2015) · Pain Research and Treatment · doi:10.1155/2015/327307 · Cited by 81 · see citing works
Javdaneh, N., Letafatkar, A., Shojaedin, S., & Hadadnezhad, M. (2020) · Clinical Rehabilitation · doi:10.1177/0269215520941910 · Cited by 42 · see citing works
- Authors
- Miller, J., Gross, A., D'Sylva, J., Burnie, S. J., Goldsmith, C. H., Graham, N., Haines, T., Brønfort, G., & Hoving, J. L.
- Affiliations
- McMaster University (CA)
- Canadian Memorial Chiropractic College (CA)
- Northwestern Health Sciences University (US)
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Gross, Anita
- Venue
- Manual Therapy
- Publisher
- Elsevier BV
- Published
- 2010-08
- Volume
- 15
- Issue
- 4
- Pages
- 334-354
- ISSN
- 1356-689X (ISSN-L)
- OpenAlex
- W2013932638
- Cited by
- 393
- References
- 3
- Citations by year
- 2026: 9 · 2025: 25 · 2024: 15 · 2023: 23 · 2022: 29 · 2021: 35 · 2020: 22 · 2019: 23 · 2018: 24 · 2017: 29 · 2016: 22 · 2015: 35 · 2014: 35 · 2013: 22 · 2012: 18
- FWCI
- 2.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Manual Therapy (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Myofascial pain diagnosis and treatment
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Keywords
- neck pain, exercise therapy, cervical manipulation, mobilization, cervicogenic headache, radiculopathy, whiplash injury, analgesia, disability, quality of life, patient satisfaction, chronic neck pain, acute whiplash
- MeSH terms
- Adult, Disability Evaluation, Exercise Therapy, Headache, Humans, Pain Measurement, Quality of Life, Randomized Controlled Trials as Topic, Patient Satisfaction, Evidence-Based Medicine, Neck Pain, Musculoskeletal Manipulations
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