DefinePK

Abstract

Objectives: To identify the efficacy of manipulation and mobilization in managing mechanical neck pain (MNP), based on their effects on pain reduction, range of motion (ROM), and functional improvement, and to assess their relative benefits in guiding clinical practice.
Methods: A systematic review was conducted using five databases (PubMed, Google Scholar, PEDro, Cochrane Library, and CINAHL) to identify randomized controlled trials (RCTs) and pilot RCTs published between 2009 and 2024. Studies involving adult participants with MNP were included, emphasizing interventions like manipulation, mobilization, and SNAGs. The quality of studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale and Cochrane RoB 2.0 framework, with data extracted on outcomes including pain intensity, ROM, and functional improvements. A narrative synthesis was performed due to heterogeneity among the studies.
Results: Twelve studies met the inclusion criteria, with PEDro scores ranging from 6 to 9, indicating fair to high quality. Both manipulation and mobilization significantly improved pain and ROM in the short term, with no clear superiority of one intervention over the other. Thoracic manipulation often yielded better immediate and short-term outcomes than cervical mobilization. SNAGs and manipulation demonstrated comparable efficacy in improving cervical ROM and reducing pain. However, limitations such as small sample sizes, variable methodologies, and short follow-up periods restricted the strength of conclusions.
Conclusion: While both manipulation and mobilization are effective for managing MNP, variability in techniques and study designs precludes definitive recommendations. Thoracic manipulation may offer additional benefits for immediate pain relief, but further research is needed to establish long-term efficacy, standardized protocols, and integration with other therapeutic modalities. The findings underscore the need for multicentre trials with robust methodologies to refine clinical guidelines for MNP management.