MECHANICAL NECK PAIN

The Effect Of Manipulation And Mobilisation in the Mechanical Neck Pain



The Effect of Manipulation and Mobilisation Techniques in the Mechanical Neck Pain

Introduction

Mechanical Neck pain is a common health complaint, with a prevalence of 15% in the United Kingdom. There are three divisions of neck pain. Acute neck pain is defined as intermittent or constant neck pain lasting less than 4 weeks, Subacute neck pain is defined as intermittent or constant neck pain lasting 4-12 weeks, and Chronic neck pain is defined as intermittent or constant neck pain lasting more than 12 weeks. Medications ordered to manage neck pain include nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, botulinum toxin type A, steroids, and opioids. There are several ways and techniques for reducing the neck pain. Lidocaine injected into trigger points reduces neck pain, Epidural cervical injections reduce chronic neck pain, Oxycodone reduces intensity and frequency of acute episodes of neck pain in people with chronic neck pain (Voerman, Sandsjö, Vollenbroek, 2007, 137-152).

Discussion

This section will discuss different techniques of Neck Pain Management. Multiple physical and occupational therapy (PT/OT) interventions for neck pain have been investigated. Manual PT interventions include, but are not limited to, soft tissue mobilization and spinal mobilization/manipulation. Manual therapy, in general, is as effective as other PT interventions in resolving neck pain. Spinal mobilization/manipulation is a technique of manual therapy that involves a continuum of skilled passive movements to the joints (e.g., spinal manipulation) and/or related soft tissues; these movements are applied at varying speeds and amplitudes, including therapeutic movement that is small-amplitude/high-velocity (Macaulay, Cameron, Vaughan, 2007, 261-267).

Thrust mobilization/manipulation involves a small-amplitude/high-velocity movement. There is strong evidence to support the use of cervical thrust and non-thrust mobilization/manipulation in the treatment of neck pain. Patients have reduced pain levels and improved function and motion for up to 2 years after the termination of treatment. Cervical thrust and non-thrust mobilization/manipulation combined with therapeutic exercise are more effective than cervical thrust and non-thrust mobilization/manipulation alone in the treatment of neck pain.

Sustained ischemic compression of a trigger point in the upper trapezius muscle is more effective in reducing neck pain than sham (i.e., inactive) ultrasound. Ischemic compression of a trigger point involves the therapist applying sustained pressure with a finger or thumb to the trigger point for up to 1 minute (Vernon, Humphreys, Hagino, 2007, 215-227). There is some evidence to support the use of thoracic thrust mobilization/manipulation to increase range of motion and reduce pain in patients with neck pain. Thoracic thrust mobilization/manipulation is more effective than thoracic non-thrust mobilization/manipulation in reducing neck pain

Land-based exercise therapy includes strengthening, stretching, endurance, and coordination exercises. There is strong evidence to support the use of strengthening, endurance, and coordination exercises in the treatment of neck pain. There is some evidence to support the use of stretching exercises of the scalenus (i.e., a deep muscle on the side of the neck), upper trapezius, levator scapulae, pectoralis minor, and pectoralis major muscles in the treatment of neck pain (Maltby, Harrison, 2008, ...