The effect of an analgesic mobilization technique when applied at symptomatic or asymptomatic levels of the cervical spine in subjects with neck pain: a randomized controlled trial

Abstract

The purpose of this single-blinded, randomized controlled trial was to compare the effects of a manual treatment technique on neck pain and movement sensation when applied in different segments of the cervical spine. Consecutive patients with neck pain (n=126) were recruited and randomly allocated to two groups (A or B). Group A received a single 4-minute pain-alleviating traction at the most symptomatic zygopophyseal joint of the cervical segment, where movement was correlated with pain. Group B received the same treatment 3 segments away from the concordant segment. Pain intensity and sensation of movement were assessed with a numeric rating scale (NRS). Statistical analysis included a t-test for paired and unpaired samples. Pre- and post-test findings demonstrated significant improvements in both types of mobilization although there was no significant difference between the two groups. Similar results have been reported in the literature for cervical manipulation. The findings of this study question the necessity of precise symptom localization tests for a pain treatment. however, limitations of the study prevent generalization of these results.

Keywords: Mobilization; Randomized Controlled Trial; Specificity of Treatment; Symptom Localization Tests; Traction.

FIGURE 1

Schematic representation of symptom localization tests with movements

FIGURE 2

Examples of symptom localization tests when extension of the neck was the painful movement

FIGURE 3

The treatment procedure used in the study: traction of the zygoapophyseal joint

FIGURE 4

Study flowchart