Cervical Spine Manual Therapy for Aging and Older Adults

Abstract

Neck pain is a common problem in aging and older adults. This narrative review synthesizes recent literature on manual therapy to the cervical spine and adjacent regions. Emphasis has been placed on summarizing high-quality randomized clinical trials, systematic reviews with a narrative synthesis or meta-analysis, and clinical practice guidelines. The synthesis suggests that although there is limited high-quality evidence, a multimodal approach including manual therapy and exercise seems safe and effective, especially in the short term, for improving outcomes in aging and older adults with neck pain. The results for cervicogenic dizziness and headache were too varied to arrive at a firm conclusion. Additional research using consistent outcome measures is needed to establish the optimal manual therapy techniques and parameters for these common cervical conditions. , PT, DPT, MS, OCS, ATC 20% of individuals 70 years of age and older experience neck pain at least one time per month. 11 Within this population, neck pain is associated with other health complaints and poorer self-rated health. 12 Physical therapy is one of the first treatment options for patients with mechanical, insidious neck pain, often with manual therapy as the preferred approach. 13 This is especially true in the elderly population where pain medication must be used cautiously because of the risk of drug interactions and associated comorbidities. 14 For this review, neck pain is classified into 4 categories: chronic nonspecific neck pain, cervical radiculopathy, cervicogenic dizziness and headache, and acute and subacute neck pain including whiplash.Although beyond the scope of this article, there are several useful reviews on pathophysiology, imaging, and conservative and surgical management of cervical spine pathology. 15-18 What follows is a synthesis of recent literature on manual therapy to the cervical spine for 4 common classifications of neck pain. Emphasis has been placed on summarizing high-quality randomized clinical trials, systematic reviews with a narrative synthesis or meta-analysis, and clinical practice guidelines. CHRONIC NONSPECIFIC NECK PAINNonspecific neck pain is defined as cervical pain without pathogenic and/or pathognomonic signs and symptoms. 13 When serious pathology and specific diseases have been excluded, the anatomical source of symptoms is difficult to establish. 19 Thus, this type of pain has also been named cervical pain of unknown origin. 20 Other popular names include the cervical syndrome, which refers to a set of disorders caused by changes in the cervical spine and the soft tissue surrounding it, with pain as the predominant symptom, 21 or chronic mechanical neck pain. Chronic nonspecific neck pain is very common, affecting up to 46% to 54% of the population. 22 It is also described as a significant predictor of sickness absence. 23 SafetyAn analytical review of orthopedic manual therapy including manipulation, specifically to the cervical spine and in an older population, should be preceded by a discussion ...

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“…[15][16][17][18][19][20] Few studies have been concerned with the effects of SNAG on the lumbar spine. 10,21,22 The rest of the available research was in the form of case reports or case series.…”

Study on Short Term Effect of Modified Lumbar Snags With Conventional Program in Non-Specific Chronic Low Back Pain Patients

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