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Saturday, 26 June 2010 10:11

Chronic Neck Pain and Chiropractic: A Comparative Study with Massage Therapy

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Chronic Neck Pain and Chiropractic:
  A Comparative Study with Massage Therapy

A report on the scientific literature 


By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP


Neck pain is a very common problem, second only to low back pain in its frequency in the general population and in doctors' offices treating musculoskeletal injuries. "The musculoskeletal system is an organ system that gives [humans] the ability to move using their muscular and skeletal systems" (Wikipedia, ,2010, http://en.wikipedia.org/wiki/Musculoskeletal). "Estimates of the prevalence of chronic neck pain vary. In a Swedish population 18.5% of females and 13.2% of males had neck pain for longer than 6 months; however, when continuous chronicity was rated, these figures were reduced to 10% and 7%, respectively. A Finnish study reported chronic neck pain in 13.5% of females and 9.5% of males. A Norwegian studyreported an overall rate of 13.8% for neck pain greater than 6 months duration; however, for subgroups with age greater than 43, the rate rose above 20%. It would appear that approximately 15% of females and 10% of men have chronic neck pain at any one time. Chronic neck pain produces a high level of morbidity by affecting occupational and avocational activities of daily living and by affecting quality of life" (Vernon, Humphreys & Hagino, 2007, p. 215).

"Manual therapy [chiropractic adjusting] is a generic therapeutic category that is composed of a variety of procedures directed at the musculoskeletal structures in the treatment of mechanical pain. Two major subcategories exist that divide these therapies into those which produce joint motion and those which do not. The first subcategory includes manipulation, mobilization, and manual traction. The second subcategory involves both generalized soft tissue therapies, such as the many types of massage, and focal soft tissue therapy, such as trigger point therapy, shiatsu, and acupressure. For this review, we used the separate therapy categories of manipulation, mobilization, manual traction, massage, and pressure techniques"
(Vernon, Humphreys & Hagino, 2007, pp. 215-216).

There are numerous systematic reviews of the treatment of neck pain by manual therapy. With few exceptions, they have included studies of manual therapies for acute, subacute, and chronic neck pain. They have also included studies of subjects with neck pain due to whiplash-type injury as well as those in which whiplash-associated disorder (WAD) was not involved. These reviews have also included studies of subjects with or without concomitant headaches and/or arm pain...Finally, these reviews have included studies where manual therapies have been combined with other therapies such as exercises, relaxation therapy, etc (so-called 'multimodal therapy'). The most recent reviews by Gross et al, Bronfort et al and the Canadian Chiropractic Association Clinical Practice Guideline have brought the evidence base up to date but are similarly broad in scope" (Vernon, Humphreys & Hagino, 2007, p. 216).

The results of these research studies included studies that  provided information of long-term outcomes, meaning they continued their study up to at least 52 weeks, with one going as high as 104 weeks (2 years) in order to determine the validity over a long period of time confirming the non-recurrence of the pain. The results of one long-term study that examined the effects of chiropractic treatment on the recovery of clinical trial patients found that approximately 70% of the patients showed full recovery. However,100% of the patients in five studies that varied in length had positive changes. It was also reported that 0%, or none of the massage therapy patients had positive outcomes at the 6 week period.

This study along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions to neck pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.comand search your state.



References


1.  Wikipedia, The Free Encyclopedia. (2010, July). Human musculoskeletal system. Retrieved from http://en.wikipedia.org/wiki/Musculoskeletal


2.  Vernon, H., Humphreys, K., & Hagino, C. (2007). Chronic mechanical neck pain in adults treated by manual therapy: A systematic review of change scores in randomized clinical trials, Journal of Manipulative and Physiological Therapeutics, 30(3), 215-227.

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