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Neck Pain Treatments Put to the Test

Spinal Manipulation and Exercise May Be Better Than Drugs at Relieving Neck Pain

By Jennifer Warner
WebMD Health News

Reviewed by Laura J. Martin, MD

Jan. 3, 2012 -- Spinal manipulation and at-home exercises may be better at relieving neck pain than relying on drugs.

But the best neck pain treatment may depend on the person.

A new study shows that spinal manipulation therapy from a chiropractor or home exercises provided by a therapist offered better neck pain relief than medication alone in people with neck pain of less than three months' duration.

Researchers say neck pain is a common problem and affects up to 3 in 4 people at some point in their lifetime.

Conventional treatment for neck pain usually consists of medication, such as anti-inflammatory drugs or pain killers, and exercise.

"Because medicines do not always work, some people use alternative treatments, such as spinal manipulation," researcher Gert Bronfort, DC, PhD, of Northwestern Health Sciences University in Bloomington, Minn., and colleagues write in the Annals of Internal Medicine.

But until now, researchers say, spinal manipulation has not been compared with medication or exercise as a treatment for neck pain.

Putting Neck Pain Treatments to the Test

In the study, researchers compared the effectiveness of spinal manipulation to exercise and drug treatment in 272 adults with neck pain of two to 12 weeks' duration.

The people were divided into three groups and received either spinal manipulation from a chiropractor, pain medication prescribed by a doctor, or two sessions with a therapist who instructed them in a series of home exercises designed to treat their neck pain. Each treatment lasted 12 weeks.

Researchers asked the people to rate their neck pain at the start of the study, at different points during treatment, and up to 12 months after treatment.

The results showed that spinal manipulation was more effective than medication for pain relief at the end of treatment and one year later. Similar improvements in neck pain were also reported by those who did the home exercises.

Overall, people with neck pain who received spinal manipulation reported greater satisfaction with their care. But researchers say this may have been because this neck pain treatment involved more frequent interaction with a provider than medication or exercise.

Personal Preference Matters

In an editorial that accompanies the study, experts say personal preference may be the determining factor in finding the best neck pain treatment "given the marginal differences in effectiveness of the different treatments."

"Patients with neck pain who are active may prefer home exercise, whereas others may want a more hands-on approach, such as manipulation or mobilization," write Bruce F. Walker, DC, MPH, DrPH, of Murdoch University and Simon D. French, PhD, MPH, of the University of Melbourne in Australia.

They say the safety and effectiveness of each neck pain treatment should be discussed, as manual manipulation of the neck carries a rare but potentially serious risk of stroke.

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SOURCES: Bronford, G. Annals of Internal Medicine, January 2012.Walker, B. Annals of Internal Medicine, January 2012.

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