The efficacy of manipulation for recent onset neck pain

颈部疼痛是非常常见的，在一般社区中的点数患病率为46%。颈部疼痛会导致严重的残疾，是导致人们请假的第二大常见伤害。颈部疼痛及其相关的残疾显然造成了巨大的社会和经济负担。颈部手法(关节的高速推力，通常与滴答声有关)被理疗师广泛用于治疗最近发作的颈部疼痛，但没有明确的证据表明其有效性。此外，手法的使用与严重的、尽管罕见的不良事件有关，如中风甚至死亡。因此，风险-收益分析并不明显有利于操纵，因为有效性尚未确定，而风险是严重的，但很少发生。拟议中的研究结果将清楚而准确地确定与更安全的松动治疗技术(对关节施加温和的振荡压力)相比，手法的疗效，目前尚无相关信息。这些信息对许多不同的学科至关重要，包括卫生专业人员、保险公司，以及制定卫生政策的管理人员。因此，我们的发现将为手法的使用提供循证指南，并最终将导致颈部疼痛物理治疗的更安全实践。

Neck pain is extremely common, with a point prevalence of 46% in the general community. Neck pain can cause significant disability, and is the second most common injury causing people to take time off work. Neck pain and its associated disability clearly poses a substantial social and economic burden. Neck manipulation (high velocity thrust of the joints, often associated with a click) is widely used by physiotherapists for the management of recent onset neck pain, but there is no clear evidence for its efficacy. In addition, the use of manipulation is associated with serious, although rare, adverse events such as stroke or even death. The risk-benefit analysis, therefore, does not clearly favour manipulation because efficacy has not been established, while the risks are serious, but infrequent. The findings of the proposed study will clearly and precisely determine the efficacy of manipulation compared with the safer treatment technique of mobilisation (gentle oscillatory pressure applied to the joints), information that is currently unavailable. This information is of vital importance to many different disciplines, including health professionals, insurance companies, and to administrators for development of health policy. Our findings will thus provide evidence-based guidelines for the use of manipulation, and will ultimately lead to safer practice of physiotherapy for neck pain.