In a 36-Year-Old Woman With Neck Pain, Will Manipulation and Mobilization Be Beneficial for Reducing Her Reports of Neck Pain?

<LEAP> highlights the findings and application of Cochrane reviews and other evidence pertinent to the practice of physical therapy. The Cochrane Library is a respected source of reliable evidence related to health care. Cochrane systematic reviews explore the evidence for and against the effectiveness and appropriateness of interventions—medications, surgery, education, nutrition, exercise—and the evidence for and against the use of diagnostic tests for specific conditions. Cochrane reviews are designed to facilitate the decisions of clinicians, patients, and others in health care by providing a careful review and interpretation of research studies published in the scientific literature.¹ Each article in this PTJ series summarizes a Cochrane review or other scientific evidence on a single topic and presents clinical scenarios based on real patients or programs to illustrate how the results of the review can be used to directly inform clinical decisions. This article focuses on a patient with neck pain. Can manipulation or mobilization reduce her neck pain?

Neck pain is a common condition, with estimates of the prevalence in the previous 12 months between 30% and 50% and activity limitations from neck pain between 1.7% and 11.5%.² The impact of neck pain on society is large due to high medical costs, time off from work, and associated disability.^3,4

Manual therapy techniques, including manipulation and mobilization, are utilized by physical therapists as one option to reduce neck pain.^5,6 Previous systematic reviews have demonstrated a benefit from manipulation and mobilization in combination with exercise but were inconclusive in regard to the specific effects from manipulation and mobilization.^7,8 In addition, debates continue in regard to the need for manipulation of the cervical spine, especially due to the potential for serious risks, such as vertebral artery dissection and stroke.^{9, …}