Cervical Manipulation… Is the Juice Worth the Squeeze? (Part 2)

And here’s part 2 of John Snyder’s blog post on cervical manipulation. Again, the comments are also worth a read.

Orthopedic Manual Physical Therapy

rambo-stallone-Neck-Snap

In Part 1, the relative risks and important screening areas prior to cervical manipulation were discussed. In this second installment, the effectiveness and a theoretical framework for utilizing cervical manipulation will be laid out.

According to the Neck Pain Guidelines published by Cleland et al, manual therapy (mobilization and manipulation) was graded both an ‘A’ (strong evidence) and a ‘1’ (evidence from high-quality RCT, prospective, or diagnostic studies) in the treatment of neck pain. These guidelines advocate both manipulative and lower grade mobilization in reducing neck pain and cervicogenic headache symptoms. Published in the same year as the clinical guidelines, Walker et al conducted a RCT looking into the effectiveness of manual therapy and exercise in the management of mechanical neck pain. Those randomized to the manual therapy and exercise group (MTE) received treatments that ranged from cervical manipulation to soft-tissue mobilization and every technique in between. The…

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