The effect of manipulation on pain and range of motion in the cervical spine: a pilot study.

OBJECTIVE

The objective of this pilot study was to determine the number of patients required for a randomized controlled trial of spinal manipulation for neck pain and to determine if there is a relationship between pain and range of motion (ROM) in the cervical spine.

DESIGN

Fifty consecutive outpatients were studied in a pretest-posttest design without long-term follow-up.

SETTING

The patients were taken from a primary cae outpatient teaching clinic specializing in back pain.

PATIENTS

All patients had unilateral neck pain without neurological deficit. The patients were selected as a consecutive sample.

INTERVENTION

All the patients received a single cervical manipulation.

MAIN OUTCOME MEASURES

Prior to and immediately after the treatment, cervical ROM was recorded on a goniometer, and pain intensity was rated on the 101-point numerical rating scale.

RESULTS

The results show an increase in all planes of post-treatment ROM and a decrease in post-treatment pain scores. Partial correlations between post-treatment ROM and 101-point numerical rating scale scores reveal a significant relationship between a decrease in pain and an increase in cervical rotation (p < .005).

CONCLUSIONS

Since the results of this pilot study are not controlled, they cannot be seen as proof supporting the clinical efficacy of manipulation for neck pain. However, the correlation between an increase in cervical rotation and a decrease in pain is clinically instructive. In addition, the outcome measures used in this study could prove to be useful in the design of future randomized controlled trials of cervical manipulation.