Cervical manipulation versus thoracic or cervicothoracic manipulations for the management of neck pain. A systematic review and meta-analysis

doi:10.1016/j.msksp.2024.102927

Musculoskeletal Science and Practice

Volume 71, June 2024, 102927

https://doi.org/10.1016/j.msksp.2024.102927 Get rights and content

Under a Creative Commons license

open access

Highlights

•
Cervical thrust or non-thrust manipulations are not more effective than thoracic manipulations in patients with neck pain.
•
Cervicothoracic manipulations are not more effective than cervical manipulations in patients with neck pain.
•
The certainty of evidence varied from moderate to very low for the outcome variables.

Abstract

Background

Cervical and thoracic thrust or non-thrust manipulations have shown to be effective in patients with neck pain, but there is a lack of studies comparing both interventions in patients with neck pain.

Objective

To investigate the effects of cervical thrust or non-thrust manipulations compared to thoracic or cervicothoracic manipulations for improving pain, disability, and range of motion in patients with neck pain.

Design

Systematic review and meta-analysis.

Method

Searches were performed in PubMed, PEDro, Cochrane Library, CINHAL, and Web of Science databases from inception to May 22, 2023. Randomized clinical trials comparing cervical thrust or non-thrust manipulations to thoracic or cervicothoracic manipulations were included. Methodological quality was assessed with PEDro scale, and the certainty of evidence was evaluated using GRADE guidelines.

Results

Six studies were included. Meta-analyses revealed no differences between cervical thrust or non-thrust manipulations and thoracic or cervicothoracic manipulations in pain intensity, disability, or cervical range of motion in any plane. The certainty of evidence was downgraded to very low for pain intensity, to moderate or very low for disability and to low or very low for cervical range of motion.

Conclusion

There is moderate to very low certainty evidence that there is no difference in effectiveness between cervical thrust or non-thrust manipulations and thoracic or cervicothoracic manipulations for improving pain, disability, and range of motion in patients with neck pain.

Prospero registration

CRD42023429933.

Keywords

Neck pain

Musculoskeletal manipulations

Spinal manipulation

Pain intensity

Disability

Cited by (0)

^☆: The protocol of this study was registered in PROSPERO (PROSPERO registration: CRD42023429933).

^☆☆: This manuscript is original and not previously published, nor it is being considered elsewhere until a decision is made as to its acceptability by the review board. Authors not declare conflicts of interest in this study. All the authors have been actively involved in the planning and enactment of the review, and have also assisted with the preparation of the submitted article. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.