Neck Pain: Combining Exercise and Manual Therapy for Your Neck and Upper Back Leads to Quicker Reductions in Pain

Neck pain is very common, but the good news is that most neck pain is not caused by serious disease.


“Mechanical neck pain” is the name healthcare professionals use when joint and muscle problems result in neck pain. Current evidence suggests that a combination of manual therapy and exercise is effective for patients with mechanical neck pain. A variety of manual therapy treatments for the neck and upper back are currently used to try to lessen neck pain. These treatments include mobilization, which slowly and repeatedly moves the neck joints and muscles, and manipulation, which delivers a single, small, quick movement to the joints and muscles. A research report published in the March 2013 issue of JOSPT focused on finding which combination of exercise and manual therapy was more effective in quickly reducing neck pain.


In this study, researchers treated 64 patients. All of the patients were prescribed mobility exercises and received mobilization of their neck. About half of these patients also received a manipulation of the upper back. After 1 week, patients who performed the exercises and received both mobilization of the neck and manipulation of the upper back noted greater relief of their neck pain. In the group that received both manual therapy techniques, 75% had significant pain reduction and 70% experienced noticeable improvement in their ability to perform daily activities. When patients only received neck mobilizations, only 19% found that their pain was reduced, and only 23% saw an improvement in their disability. The researchers concluded that the combination of exercise with neck mobilization and upper back manipulation was more effective in reducing pain in the first week of treatment.


Patients with typical neck pain may benefit from a physical therapy program that includes exercises combined with neck mobilization and upper back manipulation. Potential benefits include less pain and improved ability to perform daily activities. Although this treatment is very successful for this group of patients with neck pain, it may not be effective or appropriate for all patients. An Action Rehab physical therapist can perform an evaluation to help determine if you are a good candidate for this treatment. For more information on the treatment of neck pain, contact Action Rehab today. Action Rehab specializes in the treatment of musculoskeletal disorders.

This JOSPT Perspectives for Patients is based on an article by Masaracchio et al titled “Short-Term Combined Effects of Thoracic Spine Thrust Manipulation and Cervical Spine Nonthrust Manipulation in Individuals With Mechanical Neck Pain: A Randomized Clinical Trial,” J Orthop Sports Phys Ther 2013;43(3):118-127. doi:10.2519/jospt.2013.4221.