Manual Therapy for Neck Pain and Headache: Review

Chronic neck pain and headache are prevalent and a common source of disability in the population. The treatment of neck pain and headache is usually traditional including pharmacotherapy, physiotherapy, exercises and manual therapy. Opinions are controversial for manual therapy, which takes a significant part in the overall treatment of functional and degenerative disorders involving spine joints and muscles. The aim of manual therapy applied to cervical spine is to enhance restricted movement caused by blockage of cervical spinal joints keeping postural balance, to restore function and to maintain optimal spinal mechanics. There is little information available from randomized clinical trials to support manipulation and mobilization for treating neck pain. Cervical spine manipulations may be associated with vascular, neurological and other serious complications. These complications include radiculopathy, myelopathy, cervical disc herniation, arterial dissection and stroke, vertebral artery occlusion, Brown-Sequard syndrome, diaphragmatic paralysis, odontoid fracture, atlantoaxial injury, tracheal rupture and hearing loss. The manipulation techniques require good anatomy knowledge and clinical experience since they may cause serious complications especially of the neck area.