Chinese manipulation for mechanical neck pain: a systematic review

Clin Rehabil. 2012 Nov;26(11):963-73. doi: 10.1177/0269215512441485. Epub 2012 Apr 3.


Objective: To assess whether Chinese manipulation improves pain, function/disability and global perceived effect in adults with acute/subacute/chronic neck pain.

Data sources: CAJ Full-text Database (Chinese), Wanfang Database (Chinese), Cochrane Database (English) and Medline (English).

Review methods: Literature searching was performed with the following keywords and their combination: 'manual therapy/bone setting/Chinese manipulation', 'neck/cervical pain', 'cervical vertebrae', 'cervical spondylosis/radiculopathy' and 'randomized controlled trial/review.' Two independent reviewers selected studies, extracted data and assessed risk of bias for each included study. Randomized controlled trials or quasi-randomized controlled trials on the effect of Chinese manipulation in treating adult patients with neck pain were selected. Mean differences with 95% confidence intervals (CI) were calculated. Quality of the evidence was assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Results: Four studies (610 participants) were included in this review. There was very low-quality evidence suggesting that, compared to cervical traction in sitting, Chinese manipulation produced more immediate post-intervention pain relief (mean difference: -1.06; 95% CI: -1.37~ -0.75; P < 0.001) and improvement of global signs and symptoms (mean difference: -3.81; 95% CI: -4.71 ~ -2.91; P < 0.001). Very low-quality evidence showed that Chinese manipulation alone was superior to Chinese traditional massage in immediate post-intervention pain relief (mean difference: -2.02; 95% CI: -2.78~ -1.26; P < 0.001).

Conclusions: There was limited evidence showing Chinese manipulation could produce short-term improvement for neck pain.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Cervical Vertebrae* / injuries
  • Cervical Vertebrae* / physiopathology
  • Humans
  • Medicine, Chinese Traditional / methods*
  • Musculoskeletal Manipulations / methods*
  • Neck Pain / therapy*
  • Randomized Controlled Trials as Topic
  • Traction
  • Treatment Outcome