Table 1.

Effectiveness and efficacy (compared to inactive controls) of spinal manipulative therapy (SMT) for the management of neck pain (NP).

Comparisons studied	Conclusions from previous studies
SMT vs. inactive control	Inconsistent evidence that thoracic SMT may be superior to inactive treatment but not placeboa−d
SMT vs. mobilization	Evidence supporting thoracic SM (but not cervical) when compared to mobilizationc, e−i
SMT vs. standard medical care	Insufficient evidence for a combination of cervical and thoracic SM when compared to analgesic medication and a home exercise programj
SMT vs. physical therapy	Evidence supporting SMT when compared to physical therapya, d, k
SMT vs. exercise	Evidence supporting that SMT is not superior to exercise but may add value to unsupervised exercisej, l−n, unclear about supervised exerciseo, p
Guidelines' recommendations	SMT is recommended after advice/patient education aloneq, or in combination with exerciser, s. In acute NP, this combination may be offered before medications

^aLau et al. (45).

^bSuvarnatto et al. (41).

^cGross et al. (59).

^dCoulter et al. (37).

^eDunning et al. (52).

^fSaavedra-Hernández et al. (48).

^gMasaracchio et al. (53).

^hSalom-Moreno et al. (55).

ⁱYoung et al. (65).

^jBronfort et al. (46).

^kGonzález-Iglesias et al. (43).

^lCleland et al. (44).

^mGorrell et al. (49).

ⁿGalíndez-Ibarbengoetxea et al. (50).

^oEvans et al. (47).

^pMasaracchio et al. (42).

^qChou et al. (18).

^rCote et al. (74).

^sKjaer et al. (75).