Effects of Pain, Disability and Cervicokinesthesia After Cervical Manipulation

Effects of Pain, Disability, Widespread Pressure Pain Sensitivity, and Cervicokinesthesia After Cervical Manipulation in Patients With Mechanical Neck Pain

Cervical spine manipulation has been found to be effective in patients with mechanical neck pain. Discrepancies exist on the side of manipulation and the placebo effect of this manual intervention. In addition, some authors have proposed that spinal manipulation can alter proprioception of the cervical spine. The aim of this study will be to investigate the effects of cervical spine manipulation on pain, disability, widespread pressure pain sensitivity, and cervicokinethesia in patients with mechanical neck pain.

Cervical spine manipulation has been found to be effective in patients with mechanical neck pain. Discrepancies exist on the side of manipulation and the placebo effect of this manual intervention. In addition, some authors have proposed that spinal manipulation can alter proprioception of the cervical spine. The aim of this study will be to investigate the effects of cervical spine manipulation on pain, disability and cervicokinethesia in patients with mechanical neck pain. Patients will receive cervical spine manipulation in either right or left side of the neck and will be assessed on pain intensity, neck-related disability, widespread pressure pain sensitivity, and cervicokinethesia by an assessor blinded to the allocation group.

Patients assigned to this group will receive a cervical spine manipulation targeting the C3/C4 segment on the right side.

Patients assigned to this group will receive a cervical spine manipulation targeting the C3/C4 segment on the left side.

Patients assigned to this group will receive a sham cervical spine manipulation targeting the C3/C4 segment on both sides. No therapeuthic thrust will be applied.

We will use a high-velocity, mid-range, left rotational force to the right articular pillar of C3, on the right articular pillar of C4 with the patient in supine, with left rotation and right side-bending.

We will use a high-velocity, mid-range, left rotational force to the left articular pillar of C3, on the left articular pillar of C4 with the patient in supine, with right rotation and left side-bending.

An 11 points numerical pain rate scale (NPRS, 0-10) will be used to assess the intensity of neck pain

Pressure pain thresholds will be assessed over C5/C6 zygapophyseal joints and the tibialis anterior muscle

Inclusion Criteria: - Generalized neck-shoulder pain with symptoms provoked by neck postures, neck movement, or palpation of the cervical musculature. Exclusion Criteria: any contraindication to manipulation, e.g., positive extension-rotation test; whiplash injury; previous cervical surgery; cervical radiculopathy or myelopathy; diagnosis of fibromyalgia syndrome; having undergone spinal manipulative therapy in the previous 6 months; less than 18 or greater than 65 years of age.