Author(s): Dimitrios Lytras, Ioannis Myrogiannis and Evangelos Sykaras

Abstract:
The aim of this research was to investigate the effect of manual therapy and therapeutic exercise of the neck muscles on pain, disability and quality of life in individuals with neck pain. Method: A literature review was performed on the databases of MEDLINE, SCIENCE DIRECT and COCHRANE between September and November of 2017. The following keywords were used: chronic neck pain, exercise, manual therapy and physiotherapy. Articles inclusion criteria were randomized clinical trials which applied to individuals with chronic neck pain and contained a combination of therapeutic exercise and manual therapy for the neck muscles. Results: 10 randomized clinical trials met the inclusion criteria and were included in this review. In all of them, combined protocols of therapeutic exercise and manual techniques were applied. Few studies pointed out only short-term positive effects on pain and disability in their results. Additionally, in the majority of the studies, the manual techniques which were applied concerned mostly the cervical and thoracic spine (spinal manipulation and mobilization) and much less the neck muscles. Conclusion: There is not enough evidence to support that the combination of spinal mobilization or manipulation and therapeutic exercise can improve further symptoms and quality of life in individuals with chronic neck pain that exercise alone. To the contrary, there is some evidence on the efficacy of therapeutic exercise and manual massage but this subject remains to be elucidated. Further research is necessary using the above therapeutic combination in order to determine its short- and long-term effects on pain, disability and the quality of life of individuals with chronic neck pain.


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