Stretching exercises vs manual therapy for chronic neck pain
PainSci summary of Ylinen 2007?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★☆☆?3-star ratings are for typical studies with no more (or less) than the usual common problems. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.
This examiner-blinded randomized cross-over trial of 125 patients found pretty promising benefits to both stretching exercises and “manual therapy” for a month, and the researchers concluded that “low-cost stretching exercises can be recommended in the first instance as an appropriate therapy intervention to relieve pain, at least in the short-term.” However, there are several reasons not to get too excited about the significance of this study, perhaps the most important of which is simply that showing some improvement over 4 weeks is hardly an impressive therapeutic accomplishment, and if the study had included a control group it might well have revealed that the “therapeutic” effects weren’t much different than the natural course of the condition — i.e. everyone might have gotten better, with and without therapy of any kind.
original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
OBJECTIVE: To compare the effects of manual therapy and stretching exercise on neck pain and disability.
DESIGN: An examiner-blinded randomized cross-over trial.
PATIENTS: A total of 125 women with non-specific neck pain.
METHODS: Patients were randomized into 2 groups. Group 1 received manual therapy twice weekly and Group 2 performed stretching exercises 5 times a week. After 4 weeks the treatments were changed. The follow-up times were after 4 and 12 weeks. Neck pain (visual analogue scale) and disability indices were measured.
RESULTS: Mean value (standard deviation) for neck pain was 50 mm (22) and 49 mm (19) at baseline in Group 1 and Group 2, respectively, and decreased during the first 4 weeks by 26 mm (95% Confidence Interval 20-33) and 19 mm (12-27), respectively. There was no significant difference between groups. Neck and shoulder pain and disability index decreased significantly more in Group 1 after manual therapy (p=0.01) as well as neck stiffness (p=0.01).
CONCLUSION: Both stretching exercise and manual therapy considerably decreased neck pain and disability in women with non-specific neck pain. The difference in effectiveness between the 2 treatments was minor. Low-cost stretching exercises can be recommended in the first instance as an appropriate therapy intervention to relieve pain, at least in the short-term.
related content
- “Strength training and stretching versus stretching only in the treatment of patients with chronic neck pain: a randomized one-year follow-up study,” an article in Clinical Rehabilitation, 2008.
- “Dose-Response Relationship of Specific Training to Reduce Chronic Neck Pain and Disability,” an article in Medicine & Science in Sports & Exercise, 2006.
- “Effect of neck exercises on cervicogenic headache: a randomized controlled trial,” an article in Journal of Rehabilitation Medicine, 2010.
- “Active neck muscle training in the treatment of chronic neck pain in women: a randomized controlled trial,” an article in Journal of the American Medical Association, 2003.
- “Effects of neck muscle training in women with chronic neck pain: one-year follow-up study,” an article in Journal of Strength & Conditioning Research, 2006.
- “Neck muscle training in the treatment of chronic neck pain: a three-year follow-up study,” an article in Europa Medicophysica, 2007.
- “Dose-Response Relationship of Specific Training to Reduce Chronic Neck Pain and Disability,” an article in Medicine & Science in Sports & Exercise, 2006.
- “Effect of therapeutic exercise on pain and disability in the management of chronic nonspecific neck pain: systematic review and meta-analysis of randomized trials,” an article in Physical Therapy, 2013.
- “Long-term effects of therapeutic exercise on nonspecific chronic neck pain: a literature review,” an article in J Phys Ther Sci, 2015.
- “Exercises for mechanical neck disorders,” an article in Cochrane Database of Systematic Reviews, 2015.
- “The effects of training and detraining after an 8 month resistance and stretching training program on forward head and protracted shoulder postures in adolescents: Randomised controlled study,” an article in Manual Therapy, 2015.
These two articles on PainScience.com cite Ylinen 2007 as a source:
- PS Quite a Stretch: Stretching Hype Debunked — Stretching science shows that a stretching habit isn’t doing much of what people hope
- PS Save Yourself from Neck Pain! — A complete guide to chronic neck pain and the disturbing sensation of a “crick”
