The Effect of Biofreeze on Post Manipulation Soreness in Patients With Mechanical Neck Pain
Condition: Neck Pain
MeSH terms: Neck Pain
Study type: Interventional

Summary: 
      Background: Neck pain effects a significant number of individuals and is commonly treated
      with chiropractic cervical manipulation. The temporary increases in neck pain following
      cervical manipulation may contribute to a lack of compliance with prescribed therapy that
      following this therapy which in turn commonly contributes to protracted symptoms. Topical
      menthol has previously been shown to decrease pain shortly following application. The purpose
      of this study was to determine if patients with mechanical neck pain who received topical
      menthol gel applied to their neck prior to cervical manipulation would have less pain and
      increased neck range of motion following cervical manipulation than patients who did not
      receive menthol.

      Methods: Patients, mean ages 35 years old, with non-radicular mechanical neck pain were
      randomly assigned to a control (n=31) or a treatment (n=29) group. Five minutes before
      cervical manipulation, controls received a placebo gel applied to their neck while the
      treatment group received a menthol containing gel (Biofreeze®) applied to their neck.
      Participants rated their neck pain on a 10-point scale prior to gel application (Pre) and at
      one minute (T1), 10 minutes (T2), 20 minutes (T3), and 30 minutes (T4) post cervical
      manipulation. Six measures of neck range of motion were assessed prior to topical
      applications of gel and at T1 and T4. ANCOVA repeated measures were performed to compare pain
      ratings and neck range of motion following manipulation while controlling for Pre measures.
    

Detailed description: 
      Background: Neck pain effects a significant number of individuals and is commonly treated
      with chiropractic cervical manipulation. The temporary increases in neck pain following
      cervical manipulation may contribute to a lack of compliance with prescribed therapy that
      following this therapy which in turn commonly contributes to protracted symptoms. Topical
      menthol has previously been shown to decrease pain shortly following application. The purpose
      of this study was to determine if patients with mechanical neck pain who received topical
      menthol gel applied to their neck prior to cervical manipulation would have less pain and
      increased neck range of motion following cervical manipulation than patients who did not
      receive menthol.

      Methods: Patients, mean ages 35 years old, with non-radicular mechanical neck pain were
      randomly assigned to a control (n=31) or a treatment (n=29) group. Five minutes before
      cervical manipulation, controls received a placebo gel applied to their neck while the
      treatment group received a menthol containing gel (Biofreeze®) applied to their neck.
      Participants rated their neck pain on a 10-point scale prior to gel application (Pre) and at
      one minute (T1), 10 minutes (T2), 20 minutes (T3), and 30 minutes (T4) post cervical
      manipulation. Six measures of neck range of motion were assessed prior to topical
      applications of gel and at T1 and T4. ANCOVA repeated measures were performed to compare pain
      ratings and neck range of motion following manipulation while controlling for Pre measures.
    

Intervention name(s): BioFreeze; Placebos
Intervention type(s): Drug; Drug
Intervention description(s): The estimated surface area of the average adult's neck is 350cm and the standard dose of Biofreeze® to achieve a clinically significant effect has been sited to be 1ml/200cm2 of skin surface area. Using this data approximately 1.75 ml of the assigned gel was applied to each participant's neck (posterior, anterior, left lateral and right lateral) by the same member of the research team, 5 minutes prior to an independent practitioner performing cervical manipulation on the participant.; control gel with a similar packaging, texture, and scent as Brand X but without the active ingredient of menthol
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary purpose: Treatment