Manual therapy found superior to continued medical care
“In daily practice, manual therapy is a favorable treatment option for patients with neck pain, compared with physical therapy or continued care by a general practitioner,” wrote Dr. Jan Hoving, et al. While this doesn’t necessarily come as a surprise to doctors of chiropractic, it does astound this author since 10 professionals wrote the article-two with PT degrees, eight with PhD degrees, and four with MD degrees. The article was in the May 21, 2002, issue of the Annals of Internal Medicine, and titled, “Manual Therapy, Physical Therapy, or Continued Care by a General Practitioner for Patients with Neck Pain.”
Manual therapy in this article follows the “hands-on” definition found in CPT 2002, including mobilization and manipulation. Physical therapy is generalized to massage, modalities, and exercise therapies. Between 10 and 15 percent of the general population suffers from general neck pain-especially women and people over 50 years of age-although DCs see much higher percentages that are neither gender- nor age-specific. Manual therapy is considered a specialization within physical therapy, according to the International Federation of Orthopedic Manipulative Therapies. Manual therapists pursue specialized training to do manual therapy, including manipulation; however, as doctors of chiropractic know, all physical therapists will do manual therapy without additional specialized training. In this study, the fieldwork was performed by six physical therapists performing manual therapy and five physical therapists performing massage, modalities, and exercise therapies. Care from the general practitioner encouraged advice, discussion of ergonomics, examination, and prescription medication.
Surprisingly, “patients in the manual therapy group were more likely to report a temporary increase in neck pain that lasted more than two days after receiving therapy.” Would the manual therapy recipient have experienced the same pain if treated by a DC? Frankly, the success rate for the manual therapy group was almost twice as high as for the group that continued care with a general practitioner for neck pain (68.3 percent versus 35.9 percent). Obviously Neck Disability Index scores and range of motion improved for all three groups-especially for the manual therapy recipients. Patients receiving manual therapy had half as many absences from work as those who received drugs and advice. “Physical therapy (modalities) scored (only) slightly better than continued (medical) care.”
It is not surprising to a doctor of chiropractic that the patients in this study had pronounced perceived recovery and that normal joint motion was restored, increasing the range of motion. This is simply another study without chiropractic involvement that helps prove the efficacy of what chiropractors do in their offices each day.
Copyright American Chiropractic Association Sep 2002
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