To improve the quality of such studies, recent systematic reviews have encouraged researchers to develop sham or minimal interventions to serve as control groups for clinical trials of manual treatments for neck pain. These conflicting results are likely due to varying study methodologies and quality levels, preventing a conclusive determination of the efficacy of mechanical traction and other manual therapies for the relief of neck pain. Ĭlinical studies involving mechanical or manual therapies have demonstrated mixed clinical outcomes in patients with chronic neck pain. However, a recent systematic review recommends additional studies to determine the efficacy of specific manual therapies to clinical outcomes in this patient population. Preliminary evidence suggests that manual therapies may provide similar benefits to patients with chronic neck pain as conventional medical treatments, with better tolerance and safety profiles. In addition, non-steroidal anti-inflammatory medicines, opioids, spinal injections, and spine surgery have high-risk side effects and may deliver only marginal improvements to patients’ clinical outcomes, work-related productivity and quality of life measures. Pharmacological and surgical interventions for chronic neck pain are available, but many procedures are costly, leading to rising healthcare expenditures for this condition. Health service utilization among patients with neck pain is substantial, with 10.2 million visits to US healthcare facilities registered in 2007. The 12-month prevalence of neck pain in adults is estimated at 30 % to 50 %, with symptoms reported more frequently by women and middle-aged people. No serious adverse events were documented.Ĭhronic neck pain is a common musculoskeletal complaint associated with radiating symptoms to the head, upper extremities or thoracic regions, muscle stiffness, sensorimotor dysfunction, headache, vertigo, and psychological complaints. Most low force participants correctly identified their treatment allocation in the qualitative interview.
Participants in the medium traction force group demonstrated improvements in NDI compared to the low force group (adjusted mean difference 3.0 95 % CI 0.1 to 5.9), as did participants in the high traction force group (adjusted mean difference 2.7 95 % CI -0.1 to 5.6). Neck pain VAS demonstrated a benefit for high traction force MCD compared to the low force group. Mean traction force values were within the prescribed force ranges for each group at the C5 and occiput levels. Most participants were women (65 %) and white (92 %) with a mean (SD) age of 46.8 (12.5) years.
TOUCHCONTROL SERVER TRIAL
Forty-five participants completed the trial with three participants lost to follow-up. We randomized 48 participants, allocating an average of five each month.
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