Drs. Lori Mancuso & Godwin Sammut
Drs. Lori Mancuso
& Godwin Sammut



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Neck Pain



Chiropractors that specialize in the treatment of neck pain attempt to improve the function of the joints and the nervous system by adjusting vertebral subluxations. Manual spinal adjustments are the key to chiropractic treatment, and, in fact, the word "chiropractic" is derived from the two Greek words "cheiros" and "praktikos," which together mean, "done by hand." Chiropractic adjustments are very popular in the United States, with as many as 40 million Americans receiving regular treatments.

Source: Neck Reference.com - May 01, 2002

Neck pain is a common neuromusculoskeletal disorder in the United States, with an estimated prevalence rate of 13 to 18 % within the general population. Doctors of chiropractic commonly treat patients with neck pain. In fact, a study involving 7,527 patients revealed that 12.7% presented to DCs complaining of neck pain and a study by Wolsko, et al. found that chiropractic was used by 20% of 644 patients with back or neck pain.

Source: Michael Haneline, DC - American Chiropractic Association - October 2004

183 adults were randomly selected to receive manual therapy, physiotherapy (PT) or care from a general practitioner (GP) for six weeks. All of the patients suffered neck pain for a minimum of two weeks; 66 percent had received some form of treatment for the condition prior to enrolling in the study.

Manual therapy consisted of a variety of interventions, including hands-on techniques such as low-velocity spinal mobilization, a technique the authors noted is utilized frequently by doctors of chiropractic. Spinal manipulation was not provided, however. Treatment sessions lasted 45 minutes once per week, for a maximum of six sessions.

Physiotherapy consisted of postural relaxation exercises, stretching and functional exercises, but the mobilization techniques offered in the manual therapy group were discouraged from use. PT treatments were offered twice a week (30 minutes per session) for a maximum of 12 sessions.

Source: Dynamic Chiropractic, 2003.

Risk Factors for Neck Pain

More and more people are now making their living sitting at a desk. The use of computers have risen astronomically and many of us spend eight to ten hours a day slumped over the keyboard and staring at the monitor. When we sit with our head in a forward bent position, the posture that most desk workers assume, the ligaments that hold the facets together and the muscles in the neck are put under tremendous strain. In addition the normal forward curve of the neck becomes reversed causing more stress upon all the surrounding tissues of the neck. All of this can lead to spinal problems including disc herniation and subluxations, which are the main causes of spinal nerve irritation. Besides pain, spinal nerve irritation in the neck can cause symptoms including headaches, eye problems, giddiness, arm and hand pain and paraesthesia, as well as shoulder pain.

Source: Chiropractic Care Pte Ltd

GP care consisted mainly of a "wait and see" approach that included advice offered by a general practitioner, along with an educational booklet. Drugs were prescribed if necessary, but patients were encouraged to await "spontaneous recovery." Patients had the option of 10-minute follow-up visits with the doctor every two weeks.

Outcomes of care were measured at the start of the study and at 3-, 7-, 13- and 52-week intervals. At 26 weeks` follow-up, patients received a mail-in questionnaire. Among the outcomes measured, patients rated their perceived recovery from neck pain; intensity of pain, functional disability and utility with questionnaires.

Manual therapy was considered "the most effective treatment" in the study. After seven weeks, recovery rates in the manual-therapy group were 68 percent, compared to 51 percent and 36 percent in the PT and GP groups, respectively. Differences in recovery rates remained statistically significant at the 26-week mark, and were still superior for manual therapy at 52 weeks.

The association of psychosocial factors and chronic neck pain is well established. The UCLA Neck Pain Study offers an opportunity to address these concerns. Three-hundred-thirty-six neck pain patients presenting to a large managed-care facility between February, 1998 and June, 2000 were randomized to 8 treatment groups in a balanced 2x2x2 factorial design: spinal manipulation with and without heat therapy and with and without electrical muscle stimulation; and spinal mobilization with and without heat therapy and with and with out electrical muscle stimulation.

Two-hundred-sixty-nine patients (80%) were followed over six months. Primary outcome measures are average and most severe neck pain intensity over the past week, and neck-pain related disability. Psychosocial factors (perceived occupational stressors, locus of control, sense of personal responsibility for one`s health, perceived social support, and seeing oneself as sickly) varied considerably among the study participants, but were not related to clinical outcomes. The results were consistent across all treatment groups. Chiropractic care appears to be equally effective for patients regardless of their psychosocial situation.

Source: Michael S. Goldstein, PhD1, Hal Morgenstern, PhD2, Eric Hurwitz, DC, PhD3, and Fei Yu, PhD3.
(1) Department of Community Health Sciences, Universtiy of California, Los Angeles, School of Public Health, 10833 Le Conte Ave., Los Angeles, CA 90095, 310-825-5116, msgoldst@ucla.edu,
(2) Department of Epidemiology, University of California, Los Angeles, School of Public Health, 10833 Le Conte Ave., Los Angeles, CA 90095,
(3) Department of Epidemiology, UCLA, School of Public Health, 10833 Le Conte Ave., Los Angeles, CA 90095

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