Short-term effects of spinal thrust joint manipulation on postural sway in patients with chronic mechanical neck pain: a randomized controlled trial

Abstract

Purpose

Our aim was to compare the efficacy of spinal manipulation of the upper cervical spine (C1-C2) on postural sway in patients with chronic mechanical neck pain with the application of a combination of cervical (C3-C4), cervicothoracic (C7-T1) and thoracic spine (T5-T6) thrust joint manipulation.

Methods

One hundred eighty-six (n = 186) individuals with chronic mechanical neck pain were randomised to receive an upper cervical spine manipulation (n = 93) or three different spinal manipulation techniques applied to the cervical spine, cervicothoracic joint and thoracic spine (n = 93). Measures included the assessment of stabilometric parameters using the Medicapteurs S-Plate platform. Secondarily, neck pain was analysed using the Numeric Pain Rating Scale.

Results

We observe a decrease in the length of the centre of pressure path, average speed, medio-lateral and antero-posterior displacement with statistically significant results (p < 0.05) in the upper cervical manipulation group. Both interventions are equally effective in reducing neck pain after fifteen days (p < 0.001).

Conclusion

The application of upper cervical thrust joint manipulation is more effective in improving stabilometric parameters in patients with chronic mechanical neck pain.

Trial registration: The study was registered in the Australian and New Zealand Clinical Trial Registry (no. ACTRN12619000546156).

Implications for rehabilitation

• Patients who suffer from neck pain exhibit increased postural sway than asymptomatic subjects.

• Both spinal manipulation treatments applied in this study are equally effective in reducing neck pain.

• Spinal manipulation treatment on the upper cervical spine improves postural stability parameters.

Keywords:

• Neck pain
• spinal manipulation
• spine
• postural balance
• musculoskeletal
• manipulations

Acknowledgements

We would like to thank all the patients who made this study possible.

Ethical approval

The study was approved by the Ethics and Research Commission of the Department of Nursing, Physiotherapy and Medicine of the University of Almeria and registered in the Australian and New Zealand Clinical Trial Registry (no. ACTRN12619000546156).

URL:https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377314&isReview=true

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

Disclosure statement

The authors report no conflicts of interest.