Spinal Manipulation Superior to Medication for Neck Pain

Spinal manipulation and home exercises better than medication for relieving neck pain

THURSDAY, Jan. 5 (HealthDay News) -- For patients with acute and subacute nonspecific neck pain, symptoms improved with spinal manipulation therapy (SMT), medication, and home exercise, but spinal manipulation was found to be the most effective method for both short-term and long-term pain relief, according to a study published online Jan. 2 in the Annals of Internal Medicine.

Gert Bronfort, Ph.D., of the Northwestern Health Sciences University in Minneapolis, and colleagues evaluated the relative efficacy of medication, SMT, and home exercise with advice (HEA) for the short- and long-term treatment of 272 patients aged 18 to 65 years reporting acute and subacute nonspecific neck pain of two to 12 weeks in duration. Treatment with medication, SMT, or HEA was given for 12 weeks. First-line medication included nonsteroidal anti-inflammatory drugs, acetaminophen, or both. Second-line medication included narcotics and muscle relaxants. Spinal manipulation was performed by chiropractors and also included light massage, assisted stretching, and hot and cold packs.

The researchers found that, after 12 weeks of treatment, 56.7 percent of the SMT group achieved ≥75 percent reduction in pain compared with 33.3 percent of medication-treated and 48.3 percent of HEA-treated patients. These benefits were generally sustained, with 53.2 percent of SMT-treated, 38 percent of medication-treated, and 49.4 percent of HEA-treated patients maintaining a ≥75 percent reduction in pain at one year.

"For participants with acute and subacute neck pain, SMT was more effective than management with medication in both the short and long term; however, a few sessions of supervised instruction in HEA resulted in similar outcomes at most time points," the authors write.

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