Effects of spinal manipulation in patients with mechanical neck pain

Abstract

Objective: To analyse changes in the range of motion (ROM) and pain after spinal manipulation of the cervical spine and thoracic spine in subjects with mechanical neck pain. Methods: Spinal manipulations were performed in the cervical and thoracic spine with the Gonstead and Diversified DTV techniques. To assess cervical ROM an inclinometer was used. Cervical pain was assessed by Visual Analogue Scale (VAS). The participation of 73 patients was obtained. Ages ranged from 18 to 63 years, with an average of 42.27 years. The subjects of this study were characterized by having mechanical neck pain and restricted cervical ROM. Results: We observed a reduction in the intensity of pain perceived by patients and increased cervical ROM. There were significant differences between pre-treatment values (first visit) and the fifth and tenth visits (p<0.01), and between the fifth and tenth visits (p<0.01) in all parameters except in the cervical extension of 70º. Conclusions: The results of this study suggest that spinal manipulation of the cervical and thoracic regions with the Gonstead and Diversified DTV techniques could subjectively reduce pain and produce considerable increase in cervical ROM in adults with mechanical neck pain. RESUMO Objetivo: Analisar as alterações da amplitude de movimento (ADM) e da dor após manipulação da coluna cervical e dorsal, em indivíduos com cervicalgia mecânica. Métodos: Foram realizadas manipulações na coluna cervical e dorsal com as técnicas Gonstead e Diversificada DTV. Para avaliar a ADM cervical, utilizou-se o instrumento inclinômetro. A dor na coluna cervical foi avaliada por meio da Escala Visual Analógica (EVA). Obteve-se a participação de 73 pacientes. As idades oscilaram entre 18 e 63 anos, com média de 42,27 anos. Os indivíduos do estudo foram caracterizados por apresentar cervicalgia mecânica e restrição da ADM cervical. Resultados: Constatou-se redução da intensidade da dor percebida pelos pacientes e aumento da ADM cervical. Houve diferenças significativas entre os valores pré-tratamento (primeira consulta) e na quinta e décima consultas (p<0,01) e entre a quinta e décima consultas (p<0,01) em todos os parâmetros, exceto na extensão cervical de 70º. Conclusão: Os resultados deste estudo sugerem que a manipulação vertebral da coluna cervical e dorsal com as técnicas Gonstead e Diversificada DTV poderiam ocasionar redução subjetiva da dor e produzir aumento considerável na ADM cervical em adultos com cervicalgia mecânica. Descritores: Cervicalgia; Amplitude de movimento articular; Quiroprática; Manipulação da coluna; Vértebras cervicais. RESUMENObjetivos: Analizar las alteraciones en la amplitud de movimiento (ADM) y algias tras la manipulación vertebral en la columna cervical y dorsal, en sujetos con cervicalgia mecánica. Métodos: Fueron realizadas manipulaciones en la columna cervical y dorsal con las técnicas Gonstead y Diversificada DTV. Para evaluar la ADM cervical se utilizó un inclinómetro. El dolor en la columna cervical, fue evaluado mediante la Escala Visual Analógica (...

Isolated Neck Extensor Myopathy Associated With Cervical Spondylosis: A Case Report and Brief Review

“…Mechanical neck pain is caused by an agitated nociceptive discharge of the afferent fibers in the vertebral facet joints, intervertebral discs, and paraspinal muscles. 18 It is possible that high velocity, low amplitude spinal adjustment of the upper thoracic segment, performed in the current case, unloaded some structures and relieved the associated soft tissues and neural compromise, allowing the compressed joints and affected muscles to restore their function. 19 Pain relief following chiropractic manipulation improved proprioception of cervical paraspinal muscles.…”

“… 19 Pain relief following chiropractic manipulation improved proprioception of cervical paraspinal muscles. 18 Subsequent neck exercises improved muscle endurance and strength to keep the head upright. In cases of INEM secondary to biomechanical factors, manipulative therapies may be an alternative therapy before considering surgery.…”