Manual therapy versus therapeutic exercise in chronic neck pain

Researchers from Spain studied 3 groups of patients with nonspecific chronic neck pain. Group 1 underwent manual therapy treatment, that included such techniques as high thoracic manipulation on T4, cervical articular mobilization and suboccipital muscle inhibition. Group 2 had a therapeutic exercise plan with a progression in load (activation of deep and superficial cervical flexors and eccentric recruitment of flexors and extensors). Group 3 was in control sham treatment. Overall, 65 patients completed the study. Results showed no statistically significant difference between the experimental groups, however both had clinically relevant changes with respect to the control group. Interestingly, therapeutic exercise group reduced cervical disability index (NDI) before manual therapy group.