Chiropractic manipulation and acute neck pain: A review of the evidence

Objective: The aim of this study was to review the chiropractic and medical literature in an effort to determine the extent of current evidence supporting the use of chiropractic manipulation for the treatment of acute neck pain. Methods: A literature search of the MEDLINE/PubMed and MANTIS (Manual Alternative and Natural Therapy Index System) databases, extending from 1966 to September 2003, was conducted. Search terms included "cervical," "neck," "chiropractic," "neck pain," "patient satisfaction," and "manipulation." The inclusion criteria for article selection were studies dealing with the treatment of neck pain by means of chiropractic manipulation, regardless of the number of subjects involved or whether randomization was implemented. Results: Two hundred sixty-seven citations were identified. Most were eliminated because they either did not specifically deal with the treatment of acute neck pain with manipulation or were not written in English. Less than 10 articles marginally dealt with the treatment of acute neck pain with cervical manipulation. Moreover, there has only been one randomized clinical trial published in the English language that specifically dealt with the treatment of acute neck pain by manipulation. Other studies involved patients with neck pain of a subacute or chronic nature or treated test subjects with mobilization techniques rather than manipulation. Conclusion: There has been scant investigative research into the treatment of acute neck pain with chiropractic manipulation. Consequently, more data are needed and appropriate studies should be initiated.