Fascial treatment versus manual therapy (HVLA) in patients with chronic neck pain: A randomized controlled trial

J Back Musculoskelet Rehabil. 2021;34(6):997-1006. doi: 10.3233/BMR-191731.


Background: Chronic neck pain (CNP) is a common health problem in western industrialized nations. In recent years, the fascial tissue has attracted the attention of therapists, and a treatment of the fasciae promises to be a meaningful approach in the therapy of patients with CNP.

Objective: The aim of this study was to investigate the effectiveness of a fascial treatment (FT) compared to manual therapy (MT) and to no intervention (control group, CG) in patients with CNP.

Methods: Sixty participants with CNP were randomized into three groups. Primary outcome parameters were pain intensity as measured by the visual analogue scale (VAS), and severity of illness as measured by the Neck Pain and Disability Scale (NPAD). Secondary outcome parameter was the range of motion (ROM) of the cervical spine.

Results: Repeated measures t-tests demonstrated significant decreases with medium to large effect sizes for the FT (VAS: dR⁢M= 1.14; NPAD: dR⁢M= 0.51) and for the MT (VAS: dR⁢M= 1.15; NPAD: dR⁢M= 0.72).

Conclusion: Our results confirmed the effectiveness of MT on pain and severity of illness in the treatment of patients suffering from CNP. Furthermore, the results demonstrated the effectiveness and clinical relevance of FT for this population.

Keywords: Chronic neck pain; HVLA; fascial treatment; manual therapy; myofascial tissue; osteopathy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Cervical Vertebrae
  • Chronic Pain* / therapy
  • Disability Evaluation
  • Humans
  • Musculoskeletal Manipulations*
  • Neck Pain / therapy
  • Range of Motion, Articular
  • Treatment Outcome