Efficacy and safety of spinal manipulative therapy in the management of acute neck pain: a systematic review and meta-analysis.

Abstract

Background: Spinal manipulative therapy (SMT) is frequently used to manage neck pain; however, its efficacy and safety in treating acute neck pain (ANP) remain uncertain and require further investigation.

Objectives: This study aims to comprehensively evaluate the efficacy and safety of SMT in the treatment of ANP.

Databases and data treatment: A thorough search was conducted in PubMed, Embase, Web of Science, PEDro, and Cochrane Library databases, covering all studies from inception to March 20, 2023. Mean differences (MD) with 95% confidence intervals (CIs) were calculated to assess outcomes such as pain intensity, cervical range of motion (CROM), and disability. The PEDro Scale and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach were utilized to evaluate the methodological quality and strength of evidence.

Results: Eight randomized controlled trials (RCTs) with 965 patients were included. Their PEDro scores ranged from 4-9 (mean: 6.38, SD: 1.25). Forest plot analysis showed SMT was better than the control in reducing pain (MD = -1.53, 95% CI [-2.22, -0.83]) and improving CROM in all measured aspects. It also significantly reduced disability scores (MD = -6.20, 95% CI [-9.81, -2.59]). No serious adverse events were reported.

Conclusions: The evidence supports the use of SMT as an effective and safe intervention for reducing pain, improving CROM, and decreasing disability in patients with ANP. These findings provide valuable insights for clinical practitioners and highlight the potential of SMT as a viable therapeutic option in managing ANP.

Systematic review registration: PROSPERO CRD42021264411.