Stretching exercises vs manual therapy in treatment of chronic neck pain: a randomized, controlled cross-over trial

J Rehabil Med. 2007 Mar;39(2):126-32. doi: 10.2340/16501977-0015.


Objective: To compare the effects of manual therapy and stretching exercise on neck pain and disability.

Design: An examiner-blinded randomized cross-over trial.

Patients: A total of 125 women with non-specific neck pain.

Methods: PATIENTS were randomized into 2 groups. Group 1 received manual therapy twice weekly and Group 2 performed stretching exercises 5 times a week. After 4 weeks the treatments were changed. The follow-up times were after 4 and 12 weeks. Neck pain (visual analogue scale) and disability indices were measured.

Results: Mean value (standard deviation) for neck pain was 50 mm (22) and 49 mm (19) at baseline in Group 1 and Group 2, respectively, and decreased during the first 4 weeks by 26 mm (95% Confidence Interval 20-33) and 19 mm (12-27), respectively. There was no significant difference between groups. Neck and shoulder pain and disability index decreased significantly more in Group 1 after manual therapy (p=0.01) as well as neck stiffness (p=0.01).

Conclusion: Both stretching exercise and manual therapy considerably decreased neck pain and disability in women with non-specific neck pain. The difference in effectiveness between the 2 treatments was minor. Low-cost stretching exercises can be recommended in the first instance as an appropriate therapy intervention to relieve pain, at least in the short-term.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Disease
  • Disability Evaluation
  • Exercise Therapy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Manipulation, Spinal / methods*
  • Middle Aged
  • Muscle Stretching Exercises
  • Neck Muscles / physiopathology
  • Neck Pain / physiopathology
  • Neck Pain / rehabilitation
  • Neck Pain / therapy*
  • Pain Measurement
  • Treatment Outcome