The Effectiveness of Manipulation Treatment in Cervical Region
Condition: Neck Pain
MeSH terms: Neck Pain
Study type: Interventional

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).
    

Intervention name(s): Cervicothoracic thrust manipulation; Cervicothoracic thrust manipulation sham
Intervention type(s): Other; Other
Intervention description(s): The patient will be positioned in a supine position with arms crossed over over the trunk and holding the shoulders. The therapist will place a stabilizing hand over transverse process of T1 in pistol grip and contacted patients elbow with sternum and patient will be asked do a hip bridge while taking a deep breath than exhale. Thrust manipulation will be applied at the end of exhale.; The patient will be positioned in a supine position with arms crossed over over the trunk and holding the shoulders. The therapist will place a stabilizing hand over transverse process of T1 in pistol grip and contacted patients elbow with sternum and patient will be asked do a hip bridge while taking a deep breath than exhale. A soft compression will be applied at the end of exhale without a thrust.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Two groups with a sham control. Assessments will be performed before manipulation, immediately after first session, in the second week, and two months after the last session.
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Tape; Pain; Rehabilitation