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Back Pain Health Center

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Manual Therapy Eases Neck Pain, Cheaply

Hands-On Approach Effective, and More Cost-Effective, than Traditional Treatments


Those differences became negligible after 52 weeks follow up, however, and long-term recovery rates were similar across all three groups.

But researcher Ingeborg Korthals, PhD, of the Institute for Research in Extramural Medicine in Amsterdam, Netherlands says the overall expenses encountered by the manual therapy group were only a third of the costs associated with the other groups.

"The biggest cost factor was lower work absenteeism," says Korthals. "Almost no one in the manual therapy group missed work because they recovered so quickly and didn't shop around for other therapies after the treatment ended."

"In the physical therapy group and general practitioner group, the patients shopped around and did other therapies. In fact, a lot of them ended up in manual therapy," says Korthals.

Korthals says they were surprised to find that manual therapy was associated with lower direct and indirect costs because manual therapy is often more expensive than other treatments in the Netherlands. But the major cost-saving factor was that the patients in this group recovered quicker and were happy with the results.

George B. McClelland, DC, spokesman for the American Chiropractic Association, says the type of spinal mobilization used in this study did not involve the high velocity, low amplitude (HVLA) techniques frequently used by chiropractors in the U.S.

"But the mobilization description in the study falls well within the adjustment procedures used by chiropractors," McClelland tells WebMD. "The key here is working the joints through the range of motion but not taking it to the level that brings about an audible sound, or the cracking or popping sound typically associated with HVLA."

The researchers say the type of manual therapy used in the study is also practiced by physical therapists, but the physical therapists in the study were not allowed to include these techniques in their treatment.

"What the patient should understand is that the health care provider -- whether it's a physical therapist, chiropractor, or whomever -- will be able to enable them to get their pain down more quickly with manual therapy than compared to classical approaches with physical therapy or a family practitioner," says McClelland.

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