From the Guidelines
Primary Indication for Maximum Benefit from Cervical Spinal Manipulation (CSM)
The primary indication for maximum benefit from cervical spinal manipulation is for patients with acute neck pain, particularly those with mechanical neck pain or cervical facet joint pain, who have not responded to initial conservative management such as over-the-counter pain medications like acetaminophen or ibuprofen 1.
Conditions for Maximum Benefit
Cervical spinal manipulation may be most beneficial when used in conjunction with other therapies like exercise and heat therapy, and when performed by a licensed and experienced practitioner 1.
Precautions
Patients with chronic neck pain or those with underlying conditions such as osteoporosis, rheumatoid arthritis, or spinal instability should approach cervical spinal manipulation with caution and under close supervision 1.
Key Points
- Cervical spinal manipulation is recommended for acute neck pain.
- It should be used in conjunction with other therapies like exercise and heat therapy.
- Patients with chronic neck pain or underlying conditions should approach with caution.
- The procedure should be performed by a licensed and experienced practitioner.
From the Research
Primary Indication for Maximum Benefit from Cervical Spinal Manipulation (CSM)
The primary indication for maximum benefit from cervical spinal manipulation (CSM) can be identified by examining the outcomes of various studies.
- The studies suggest that CSM is beneficial for patients with neck pain, particularly those with acute or chronic mechanical neck pain 2, 3, 4, 5, 6.
- A systematic review of the literature found that spinal manipulation and mobilization probably provide at least short-term benefits for some patients with neck pain and headaches 3.
- Another study found that patients with neck pain had an average 53.8% and 48.4% reduction in their pain and disability, respectively, after receiving chiropractic manipulation 4.
- A randomized controlled trial found that a single session of cervical spine manipulation provided significant improvements in self-reported neck disability and perceived improvement in people with nonspecific neck pain 5.
- However, the results of another study suggest that manipulation of the cervical and thoracic spine leads to a greater reduction in disability at one week than after manipulation of the cervical spine alone, whereas changes in pain and range of motion are not affected differently 6.
Patient Characteristics
The studies also provide information on the characteristics of patients who may benefit from CSM.
- Patients with acute or chronic mechanical neck pain may benefit from CSM 2, 3, 4, 5, 6.
- Patients with concomitant neck pain and headaches may have statistically significant higher pretreatment and posttreatment disability and pain scores than those with only neck pain 4.
- The duration and severity of symptoms may also affect the outcome of CSM, with patients with acute or subacute symptoms tend to have better outcomes than those with chronic symptoms 4.