“…The combination of mobilization and manipulation and physical modalities when compared with placebo, education, cervical collars, exercise, ultraviolet radiation, direct galvanic current, ultrasound, and massage was not found to produce any difference in terms of pain reduction, improvement in function, or global perceived effect in patients with acute, subacute, or chronic neck pain (57). What the findings of this systematic review imply, in line with the previous systematic review (55), is that the seemingly best combination of mobilization and manipulation is with exercise and advice and not with other physical modalities. Another systematic review comparing mobilization and manipulation techniques with exercise pointed to minimal beneficial effects of these techniques, in comparison to exercise, relevant to pain and function (58).…”