Steskal Chiropractic, Omaha Nebraska

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Monday - Wednesday - Friday                                           Steskal Chiropractic

9:00AM to Noon                                                                 10615 Fort Street,

3:00-6:00 PM                                                                      Omaha, NE 68134

Get Directions -            1-402-496-9300






Article Index



In 2002, physical therapist Jan Hoving and colleagues published a randomized clinical trial in the treatment of acute neck pain involving physician care v. exercise v. manual manipulative therapy. The article was published in the Annals of Internal Medicine and titled (15):


Manual Therapy, Physical Therapy, or Continued Care by a General Practitioner for Patients with Neck Pain A Randomized, Controlled Trial


In this study, “Manual Therapy” was defined as:


“Orthopedic manipulative (manual) therapy is a specialization within physical therapy and provides comprehensive conservative management for pain and other symptoms of neuro-musculo-articular dysfunction in the spine and extremities.”


These authors made the following points and conclusions:


“At 7 weeks, the success rates were 68.3% for manual therapy, 50.8% for physical therapy, and 35.9% for continued [physician] care.”


“Manual therapy scored consistently better than the other two interventions on most outcome measures.”


“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.”


“Primary care physicians should consider manual therapy when treating patients with neck pain.”


“The success rates for manual therapy were statistically significantly higher than those for physical therapy.”


“Patients receiving manual therapy had fewer absences from work than patients receiving physical therapy or continued [physician] care.”


“In our study, mobilization, the passive component of the manual therapy strategy, formed the main contrast with physical therapy or continued care and was considered to be the most effective component.”




In 2012, Gert Bronfort, DC, PhD, and colleagues from Northwestern Health Science University, published a study in the Annals of Internal Medicine, titled (16):


Spinal Manipulation, Medication, or Home Exercise With Advice for Acute and Subacute Neck Pain A Randomized Trial


This study sought to determine the relative efficacy of spinal manipulation therapy (SMT), medication, and home exercise with advice (HEA) for acute and subacute neck pain in both the short and long term. This was a randomized, controlled trial using 272 subjects aged 18 to 65 years who had nonspecific neck pain for 2 to 12 weeks. The intervention was 12 weeks of SMT, medication, or HEA.


The primary measurement outcome was participant-rated pain, measured at 2, 4, 8, 12, 26, and 52 weeks after randomization. Secondary measures were self-reported disability, global improvement, medication use, satisfaction, general health status (Short Form-36 Health Survey physical and mental health scales), and adverse events. The main conclusion from these authors is:


“For [neck] pain, SMT had a statistically significant advantage over medication after 8, 12, 26, and 52 weeks.”


“For participants with acute and subacute neck pain, SMT was more effective than medication in both the short and long term. However, a few instructional sessions of HEA resulted in similar outcomes at most time points.”


“Our results suggest that SMT and HEA both constitute viable treatment options for managing acute and subacute mechanical neck pain.”