Massage, which applies pressure to the soft
tissues of the body, such as the muscles.
Mobilization, which uses
slow, measured movements to twist, pull, or push bones and
Manipulation, which uses pressure on a joint. It can be done with the hands or a special device. The careful, controlled force used on the joint can range from gentle to strong, and from slow to rapid. Sometimes other joints of the body are also worked on to help treat the spine.
Manual therapy is sometimes used for neck pain. A review of multiple studies shows that
exercise and mobilization, either separate or used together, are likely to be
helpful in the treatment of nonspecific neck pain. (Pain is “nonspecific” when its cause isn’t clear.) A combination of exercise and manual therapy is likely to work the best.footnote 1 And manual therapy may be better than medicine for relieving nonspecific neck pain.footnote 2
Manipulation is not recommended if you have nerve-related problems that are very severe or getting worse.
Before you try
manual therapy for neck pain, think about the following:
First, try home treatment, like heat, ice, pain
relievers, and mild exercise or stretching. These things may help your neck
pain the best.
If you have severe pain or your symptoms are getting worse, or if you’re getting new symptoms, consider talking to your doctor. Manipulation may not be the right treatment for you.
Good manual therapy will include information
on self-care and strength exercises.
If you choose to see a health care provider who does manual therapy, find one who is willing to work with your other health care providers.
Do your research. Not all manual therapy is the same. And
there isn’t a good way to tell what will be helpful and what won’t. If you decide to try it,
talk to a couple of different manual therapy providers before you choose and get treated by one.
Bhagawati D, Gwilym S (2015). Neck pain with radiculopathy. BMJ Clinical Evidence. http://clinicalevidence.bmj.com/x/systematic-review/1103/overview.html. Accessed March 1, 2016.
Bronfort G, et al. (2012). Spinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: A randomized trial. Annals of Internal Medicine, 156(1, Part 1): 1-10.
ByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP – Emergency Medicine E. Gregory Thompson, MD – Internal Medicine Adam Husney, MD – Family Medicine Kathleen Romito, MD – Family Medicine