Abstract
Objectives
To assess the efficacy of spinal manipulation versus ultrasound in the treatment of patients with neck pain.
Design
Randomized clinical trial.
Setting
Technikon Natal Chiropractic Clinic—Durban, South Africa
Subjects
Thirty randomly allocated subjects with neck pain, (aged between 16 and 60 years), responded to advertisements from the “college” (Technikon Natal, Department of Chiropractic), in the local newspapers and from the radio.
Method
Two groups of subjects were treated. Group 1 received spinal manipulation and Group 2 received ultrasound. Both groups were assessed with a CROM goniometer used for cervical range of motion assessments, algometer measurements (to assess pain thresholds), completion of the Numerical Pain Rating Scale 101 (for intensity of pain), level of disability using the CMCC Neck Disability Index, and the Short Form McGill Questionnaire to assess for the sensory dimension of pain.
Results
Ultrasound increased only right rotation range of motion of the neck, whereas spinal manipulation increased left rotation, right lateral flexion (ranges of motion of the neck) and decreased disability.
Conclusion
From the results it appears that both ultrasound and adjustments are useful in treating mechanical neck pain; however, it appears that adjustments were more effective in restoring overall mobility and in decreasing cervical disability than ultrasound alone.
Key Indexing Terms: Chiropractic, Ultrasound, Neck Pain
Footnotes
This study was submitted as a dissertation to the Faculty of Health, in compliance with the requirements for the Master's degree in Technology: Chiropractic, at Technikon Natal.
References
- 1.Cassidy JD, Quon JA, Lafrance LJ, Yong-Hing K. The effect of manipulation on pain and range of motion in the cervical spine. J Manipulative Physiol Ther. 1984;15:495–500. [PubMed] [Google Scholar]
- 2.Howe DH, Newcombe RH, Wade MT. Manipulation of the cervical spine—a pilot study. J Royal College of Practitioners. 1983;33:574–579. [PMC free article] [PubMed] [Google Scholar]
- 3.Koes BW, Bouter LM, van Mameren H, Essers AHM, Verstegen GMJR, Hofhuizen DM, Houben JP, Knipshild PG. A blinded randomized clinical trial of manual therapy and physiotherapy for chronic back and neck complaints: physical outcome measures. J Manipulative Physiol Ther. 1992;15:16–23. [PubMed] [Google Scholar]
- 4.Aker PD, Gross AR, Goldsmith CH, Peloso P. Conservative management of mechanical neck pain: systematic overview and meta-analysis. Br Med J. 1996;313:1291–1296. [PMC free article] [PubMed] [Google Scholar]
- 5.Mennell J. The validation of the diagnosis “joint dysfunction” in synovial joints of the cervical spine. J Manipulative Physiol Ther. 1990;13:7–12. [PubMed] [Google Scholar]
- 6.Fitz-Ritson D. The chiropractic management and rehabilitation of cervical trauma. J Manipulative Physiol Ther. 1990;13:17–25. [PubMed] [Google Scholar]
- 7.Korr IM. The neurobiologic mechanisms in manipulative therapy. Plenum Press; New York: 1978. [Google Scholar]
- 8.Nyborg WL, Ziskin MC. Biological effects of ultrasound. Churchill Livingstone; New York: 1985. [Google Scholar]
- 9.Gam AN, Johannsen F. Ultrasound therapy in musculoskeletal disorders—a meta-analysis. Pain. 1995;63:85–91. doi: 10.1016/0304-3959(95)00018-N. [DOI] [PubMed] [Google Scholar]
- 10.Szaraz ZT. Compendium of chiropractic technique. Technical Publications; Toronto: 1990. [Google Scholar]
- 11.Fischer AA. Pressure threshold meter: its use for quantification of tender spots. Arch Phys Med Rehabil. 1986;67:836–838. [PubMed] [Google Scholar]
- 12.Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain. 1986;27:117–126. doi: 10.1016/0304-3959(86)90228-9. [DOI] [PubMed] [Google Scholar]
- 13.Melzack R. The McGill pain questionnaire: major properties and scoring methods. Pain. 1975;1:277–299. doi: 10.1016/0304-3959(75)90044-5. [DOI] [PubMed] [Google Scholar]
- 14.Vernon H, Mior S. The neck disability index: a study of reliability and validity. J Manipulative Physiol Ther. 1991;14:409–415. [PubMed] [Google Scholar]