The Effectiveness of Manipulation Treatment in Acute Cervical Region Pain
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Neck Pain
- Sponsor
- Abant Izzet Baysal University
- Enrollment
- 84
- Locations
- 2
- Primary Endpoint
- Pain pressure threshold
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
Neck pain is the second most common musculoskeletal pain after lumbar pain. Prevalence is 27.2% female and 17.4% in male population (1, 2). Approximately 1/3 of acute onset neck aches become chronic. It causes increasing the cost of treatment and also the loss of labor (3, 4).
Detailed Description
Acute neck pain is often caused by mechanical causes and can be classified as rheumatic diseases, infectious and tumoral pathologies, metabolic bone diseases such as osteoporosis and osteomalacia, pain reflected the cervical region. A-V malformation and syringomyelia are the causes of chronic cervical pain (5). Mechanical neck pain is a non-radicular pain caused by local musculoskeletal structures and is characterized by a spasm of the cervical muscles. (6, 7). Posture, emotional stress, cold and fatigue are etiologic causes, and pain is also reflected in the cervical, occipital and scapular regions depending on the severity of muscle spasm and the presence of trigger point in myofascial pain syndrome (9, 10). Many authors have suggested that facet joints are associated with mechanical dysfunction as a common cause of cervical pain (8-10). The pain in the head and neck region affects the quality of life, cognitive and functional status of the person. The most important difficulty and failure in the treatment of such pain arise from the inability to diagnose the disease correctly. Good anatomical and biomechanical properties of the region, comprehensive anamnesis, physical examination under static and dynamic conditions, laboratory and radiological examinations are the most important milestones of diagnosis (12). In most cases, medical treatment and physical therapy modalities (superficial and deep heat, electrotherapy, laser, traction, massage, spa) are sufficient for pain relief and recovery of function, but interventional procedures and surgical procedures are needed for the fewer patient. Recently, spinal mobilization and manipulation techniques can be used to relieve pain and restore function in the early stages. Although it is a safe method, in order to prevent the rare complications it is necessary to determine the indications of treatment correctly, to exclude contiguous cases and to apply the manipulation by experts (12).
Investigators
Ramazan KURUL
Assistant Professor
Abant Izzet Baysal University
Eligibility Criteria
Inclusion Criteria
- •Clinical diagnosis Nonspecific neck pain (NSNP)
- •Symptoms should last longer than 2 weeks
Exclusion Criteria
- •Any known cause such as radiculopathy or neurological diseases,
- •History of neck surgery,
- •History of vertebral fracture,
- •Osteoporosis,
- •Tumor or a mass in the vertebral column,
- •Any spinal thrust manipulation contraindication,
- •Medication usage such as antiinflammatory or analgesic which might effect outcome assessments,
- •History of spinal manipulation
Outcomes
Primary Outcomes
Pain pressure threshold
Time Frame: two weeks
Pain pressure threshold (PPT). was assessed with an analogue algometry (Baseline, FEl Inc. White Plains, NY,USA) with 1 cm2 rubber tip was used to measure the pain pressure threshold. Algometer perpendicularly placed over spinous process of T1 on prone position and pressure progressively increased 1 kg/s until patients verbally reported pain under the tip of algometer or referring pain. Measurement repeated three times and average score recorded.
Secondary Outcomes
- Cervical range of motion(two weeks)
- Visual analog scale(two weeks)
- Global Perceived Effect Scale(two weeks)
- Neck Disability Index(two weeks)