Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2017. / Aim: There is a paucity in the literature regarding the effectiveness of the Impulse Adjusting Instrument® (IAI) in treating myofascial trigger points (MFTPs) and regarding the effectiveness between dry needling and the IAI in the treatment of MFTPs. There are many limitations and an array of contraindications for dry needling. Therefore, an alternative method should be sought as this will be beneficial to the patient. Thus, the aim of this study was to determine the effectiveness of the IAI compared to dry needling in the treatment of MFTPs found in the upper trapezius muscle. Methodology: This study was a randomised single-blinded clinical trial. This study consisted of 41 participants between the ages of 18 and 40 who were divided into two groups. The participants were randomly allocated into their respective groups using a blinded allocation method that was drawn up by the statistician. Groups were divided into dry needling (Group one (n=18)) and IAI (Group two (n=23)) treatment groups. Subjective neck pain level was determined using a numerical pain rating scale (NRS). The neck disability index (NDI) subjectively assessed the effect neck pain had on the participants’ activities of daily living before and after treatment. The Patients Global Impression of Change (PGIC) tool was used to determine the participants’ subjective impression of treatment outcomes since the beginning of the treatment. Objective pain pressure thresholds (PPT) were measured with an algometer. Objective cervical range of motion (CROM) in lateral flexion (LF) was measured with a goniometer. Each participant had four visits over a two week period, which included three treatments and a final visit for final measurements. Data was analysed using IBM SPSS version 23. Repeated measures ANOVA was used to examine the effect on each outcome measure. Directional trends in effectiveness were drawn up using profile plots to assess the direction and trends of the effects. A p value of < 0.05 was considered to be statistically significant. Results: Intra-group and inter-group statistical analysis revealed all subjective measurements improved in both groups with no significant differences between the groups. With respect to objective measurements, there was no statistical improvement in LF CROM and dry needling had no improvement in PPT. Impulse Adjusting Instrument trigger point therapy showed an increase in PPT, however, when compared to dry needling there was no statistical difference in PPT. Conclusion: The conclusion for this study states that the trends in each of the outcomes suggest that the IAI is as effective as dry needling for the treatment of MFTPs. / M

M.Tech. (Chiropractic) / Neck pain is a common and costly complaint in society and many are made to believe that their neck pain is caused by pinched nerve, compressed disk, arthritis or displaced cervical vertebrae, when in reality the pain may be solely due to referral from myofascial trigger points in overworked or traumatized muscles of their upper back and shoulders. Travel and Simons (1999) demonstrated trapezius muscle of the neck, back and shoulder as the main cause of mechanical neck pain and stiffness. The aim of this study was to compare the effects of trigger point therapy using an activator instrument versus myofascial dry needling in combination with cervical spine adjustment in the treatment of those with acute or chronic neck pain associated with active trigger point 1 (TrP 1) or trigger point 2 (TrP 2) of upper trapezius muscle, with regards to pain and disability, pressure pain threshold and cervical spine range of motion. The clinical study consisted of forty participants, from the ages of 18 and 45, randomly allocated into two groups of twenty individuals each. Potential participants were examined and accepted based on inclusion and exclusion criteria. Group 1 received activator trigger point therapy to upper trapezius TrP 1 or 2 with chiropractic adjustment to restricted segments of the cervical spine, and group 2 received myofascial dry needling of upper trapezius TrP 1 or 2 with chiropractic adjustment to restricted segments of the cervical spine. Participants were treated four times over a period of two weeks. Subjective data was collected using the Vernon-Mior Neck Pain and Disability Index and a Visual Analog Scale. Objective data was collected using an algometer to measure pressure pain threshold of trapezius TrPs muscles, and a goniometer to measure cervical spine range of motion. All data was collected at the first and third visits prior to treatment, and at the fifth visit. The statistical analysis was conducted using nonparametric tests. Friedman’s test was used to assess whether neck pain, disability, cervical spine range of motion and pressure pain threshold varied over the three time intervals. Wilcoxon Signed Ranks Pair test was used for assessment of comparability of the results in each group separately, and the Mann-Whitney U test was used for comparison of the accumulated data in the two groups.

M.Tech. / Purpose: This study aims to compare the effects of Chiropractic manipulative therapy of the cervical spine in conjunction with SpiderTech therapy in the treatment of chronic neck pain with regards to pain, disability and cervical spine range of motion. Method: This study consisted of two groups of 15 participants between the ages of eighteen and forty, ensuring equal male to female and age ratios. The potential participants were examined and accepted according to the inclusion and exclusion criteria. The method of treatment administered to each participant was determined by group allocation. Group 1 received chiropractic manipulative therapy to restriction(s) of the cervical spine, with the SpiderTech Neck Spider applied to the posterior aspect of the neck. Group received chiropractic manipulative therapy to restriction(s) of the cervical spine only. Procedure: Treatment consisted of 6 treatment sessions with an additional follow up consultation, with two consultations being performed per week interval. Subjective data and objective data was taken at the beginning of the first, fourth and seventh sessions. The subjective data collected was in the form of a Numerical Pain Rating Scale and a Vernon- Mior Neck Pain and Disability Index. Objective data consisted of cervical spine range of motion readings taken using a Cervical Range of Motion measuring instrument (CROM). Analysis of collected data was performed by a statistician. The Chiropractic manipulative techniques used were based on restrictions identified during motion palpation and were applied at the first six consultations, with the seventh consultation consisting of data gathering only. Results: Statistically significant changes were noted in group 1 and group 2 with reference to pain and disability, and in group 1 and group 2 with reference to cervical spine range of motion. Clinically significant improvements in group 1 and group 2 were noted over the duration of the study with reference to pain, disability and cervical spine range of motion. However, the combined treatment group (group 1) had a clinically greater effect than that of the manipulation only group. Conclusion: The results show that both Chiropractic manipulative therapy, as well as Chiropractic manipulation in conjunction with the SpiderTech Neck Spider are effective treatment protocols in decreasing pain and disability and increasing cervical spine range of motion in patients with chronic neck pain. However, neither treatment protocol proved to be preferential. When compared to Chiropractic manipulative therapy alone, SpiderTech therapy in conjunction with Chiropractic manipulative therapy has a clinically larger effect on neck pain, disability and range of motion of the cervical spine.

M.Tech. (Chiropractic) / Mechanical neck pain is the most common type of cervical spine pain encountered. It is also referred to as simple or non-specific neck pain and is common in all groups of people (Plaugher, 1993). A majority of individuals with neck pain do not experience a resolution in their pain and disability and this thus results in chronicity (Cote, Cassidy, Carrol and Kristman, 2004). Chiropractic manipulative therapy (CMT) is a specific form of articular manipulation, especially of the vertebral column. This is performed either manually, mechanically, actively or passively in order to restore normal articular alignment and function (Gatterman, 2005). Proprioceptive neck exercises are designed to retrain the cervical musculature to regain its position sense in space. Specific exercises are designed to locate the head to a neutral position and then to do a series of movements in other planes, and then to return the head to the neutral position (Revel, Minguet, Gergoy, Valliant and Manuel, 1994). Chiropractic manipulative therapy does have documented positive effects on the proprioceptive system within the cervical spine (Palmgren, 2006) as does proprioceptive exercises (Sarig-Bahat, 2003; Revel, Minguet, Gergoy, Vaillant, Manuel, 1994). The desired effects of combining both these treatments would be to increase the response rate in patients suffering from chronic mechanical neck pain. The aim of this study was to compare the effects of Chiropractic manipulative therapy (CMT) and proprioceptive neck exercises as stand-alone treatment protocols, as well as a combination treatment protocol with regards to neck pain, disability, cervical spine range of motion and Head Repositioning Accuracy (HRA). Participants were recruited from the University of Johannesburg Chiropractic Day Clinic. They were eligible to participate in the study once they met the inclusion and exclusion criteria. Participants were recruited by means of advertisements that were placed around the respective campuses of the University of Johannesburg as well as by word of mouth. Thirty participants, who presented with chronic mechanical neck pain, volunteered for this randomised comparative clinical study. The participants, aged between 18 - 40, were randomly divided into three groups of ten, with a half female to male ratio. Group 1 received Chiropractic manipulative therapy to the restricted joints in the cervical spine, Group 2 received proprioceptive neck exercises and Group 3 received a combination of both treatments. Participants were treated for a total of 6 visits over a three week period. Subjective and objective measurements were taken at the beginning of visits 1, 4 and at a final visit 7 during which only measurements were taken. Subjective measurements consisted of the Vernon-Mior Neck Pain and Disability Index (VMNPDI) and the Numerical Pain Rating Scale (NPRS) to assess the participants‟ neck pain and disability as well as their perception of pain. Objective measurements were obtained by using the Cervical Range of Motion device (CROM) as well as measuring the Head Repositioning Accuracy (HRA) as described by Revel, Andre-Deshays and Minguet (1991). Based on the results of the study, it could be concluded that both Group 1 (Chiropractic manipulative therapy to the restricted joints in the cervical spine) and Group 3 (a combination of cervical spine manipulation and proprioceptive neck exercises) can be used effectively to treat chronic mechanical neck pain and improve HRA. Group 1, 2 and 3 showed statistical improvements in certain areas and clinical improvements in all areas over time. It could not be statistically concluded whether one treatment is superior to the other, although clinically, Group 1 and Group 3 seemed to be more effective. Considering that Group 3 is a combination of cervical spine manipulation and proprioceptive neck exercises, it could be considered as a valid treatment protocol for chronic mechanical neck pain and improving HRA and could thus be used in a clinical setting.

M.Tech. (Chiropractic) / Purpose: Patients presenting with mechanical cervical spine pain demonstrate myofascial trigger points of the surrounding cervical spine musculature (De Las Penas, Alonso-Blanco, Alguacil-Diego and Miangolarra-Page, 2006). Myofascial trigger points, from specifically the cervical spine musculature, have been seen to be involved to a large extent with not only the local mechanical cervical spine pain but also the accompanying referred pain patterns and symptoms (De Las Penas, Alonso-Blanco and Miangolarra-Page, 2007). The purpose of this study is to compare the efficacy of ischaemic compression and laser therapy respectively, applied to an active myofascial trigger point in participants with acute mechanical cervical spine pain associated with an active trapezius myofascial trigger point TP1, with regards to pain, activities of daily living, pressure pain threshold and cervical spine range of motion. Method: This study consisted of two groups, the ischaemic compression group with fifteen participants and the laser group with fifteen participants. The participants were between the ages of eighteen and forty-five years of age. Prior to becoming a participant of this study, individuals were assessed according to the inclusion and exclusion criteria, a clinical case history, physical examination, cervical spine regional examination and upper trapezius muscle palpation to assess for an active trapezius myofascial trigger point 1. Treatment was applied to the active trapezius myofascial trigger point 1 only, from which the subjective and objective results were based. Procedure: Each participant was treated six times over a period of two consecutive weeks. Prior to initiation of the treatment, each participant was requested to complete the Vernon-Mior Neck Pain and Disability Index questionnaire and the Visual Analogue Scale. Algometer readings were obtained over the trapezius myofascial trigger point 1, bilaterally. The Cervical Range of Motion (CROM) goniometer was used to obtain numerical values for the participant’s active cervical spine ranges of motion: flexion, extension, lateral flexion, and rotation. Ischaemic compression and laser therapy, group 1 and group 2 respectively, then each received treatment of the active trapezius myofascial trigger point 1, for a total of six treatment sessions. Both subjective and objective data readings were obtained before the 1st, 4th, and at the 7th final consultation.

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic at the Durban University of Technology, 2009. / It has been noted that in many recent research studies mechanical neck pain is a serious problem in the world today. There are epidemiological and statistical studies documenting the high incidence and prevalence of mechanical neck pain, which effects people’s daily living (Drew, 1995; Ferrari and Russell, 2003; Cote et al., 2000, Venketsamy, 2007 and Haldeman et al., 2008). Background: Treatments for chronic neck pain, which are non-surgical, appear to be the most beneficial for patients (Haldeman, 2008). In brief, the presentation of chronic mechanical neck pain is defined as localised, asymmetrical neck pain with restricted range of motion and dysfunctional musculature (Grieve, 1988). The muscular dysfunction known as the upper cross syndrome is defined as tightness of the upper trapezius, pectoralis major and levator scapulae and weakness of rhomboids, serratus anterior, middle and lower trapezius and deep neck flexors. These muscles are responsible for stabilizing the scapula and the patient may present with rounded, elevated shoulders and anterior head carriage when diagnosed with this syndrome (Liebenson, 1996). Clinical trials conducted by Cassidy et al., (1992 a, b) concluded that spinal manipulative therapy (SMT) was highly effective in treating mechanical dysfunctions within the cervical spine. However, due to multi systemic involvement of the muscular, neural and passive systems in mechanical neck pain, the treatment may need to target all three of the subsystems of spinal stability to be most effective (Panjabi, 1992 a, b; Lee et al., 1998; Lee 2004 and Richardson et al., 2002). No research has been conducted on the effects and benefits of treatment directed on the cervical spine and upper cross syndromes. This research will compare scapula stabilization training and SMT to SMT in isolation, as a treatment for chronic mechanical neck pain. Objectives: The purpose of this study was to determine the effect that scapula stabilization had on chronic mechanical neck pain. Pilates exercises were used to strengthen and stabilize the scapula muscles (this included stretching out the hypertonic musculature of the upper cross syndrome). The aim was to improve posture as well as to decrease the mechanical stress on the neck. SMT was also concomitantly used to correct any cervical restrictions that were present. These results were then compared to the results of a group that only received spinal manipulative therapy. The null hypothesis was that the intervention group would not respond differently to the treatment protocol in terms of the subjective and objectives measurements. iv Method: This clinical trial was conducted on a sample population of 30 patients with chronic mechanical neck pain. Each patient was assigned to one of two groups (n=15) according to convenience sampling. Both groups received SMT to the cervical spine, while group B (intervention group) also received pilates classes twice weekly for four weeks, which retrained the scapula stabilization muscles to function optimally. The patients each underwent six spinal manipulative treatments over four weeks and a seventh consultation in the fifth week for data collection. Both groups were evaluated in terms of subjective and objective clinical findings. Subjectively the assessment included 2 questionnaires (Numerical Pain Rating Scale and Canadian Memorial Chiropractic College [CMCC] neck disability index). Objective assessment included cervical motion palpation, Cervical Range Of Motion goniometer (CROM) measurements, scapula stabilization tests and a postural analysis with the use of digital photography. The statistics were completed under the guidance of a biostatistician, from the College of Health Science, University of KwaZulu – Natal, (Esterhuizen, 2008) who analyzed the captured data with the use of SPSS version 15. All outcome measures were quantitative. Repeated measures ANOVA testing was used to assess the presence of a different effect for each outcome measure over time between the two treatment groups. A statistically significant time by group effect would indicate a significant treatment effect. The minimum significance level was 0.05. The trends and direction of the effect were assessed via profile plots. Result: According to the statistical analysis, both groups showed improvements - subjectively and objectively - with regards to chronic mechanical neck pain, which is in keeping with the literature. In terms of the inter-group comparison the SMT group (Group A) showed a more constant improvement in range of motion, pain and disability indexes with the SMT only group while the SMT and pilates group (Group B) showed a greater effect in stabilizing the scapula and increasing the functionality of the surrounding musculature. Conclusions and Recommendations: The intervention treatment (Group B) did not have a greater effect on the short-term treatment of chronic mechanical neck pain than the reference group (Group A). It was also evident that the intervention group (Group B) often continued to improve when the SMT (Group A) only group often regressed at the follow up sessions. This improvement was either not significant enough or v the follow up session did not allow for enough time for a true reflection to be noted. It is recommended that more research be carried out to gain conclusive results indicating whether there is a more beneficial long term result to this treatment protocol.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic Durban University of Technology, 2013. / Background : Chronic non-specific neck pain is a common condition that negatively affects cervical muscle functioning and activities of daily living. Combined exercise and mobilisation are currently recommended as the most effective treatment for this condition. Mobilisation, such as mobilisation of the cervical spine, provides short-term pain relief and affects neural activity, while the craniocervical flexion exercise provides immediate pain relief and activates the deep cervical flexors. The short-term effect of mobilisation and the craniocervical flexion exercise have not been compared. Objectives : This study aimed to compare mobilisation and craniocervical flexion exercise in terms of subjective and objective outcome measures at a short-term follow-up consultation for the treatment of chronic non-specific neck pain. The null-hypothesis was that the mobilisation group would not respond differently to the craniocervical flexion exercise group. Method : A group of thirty females between the ages of 20 and 35 complaining of non-specific neck pain for more than three months were randomly allocated into either the mobilisation or craniocervical flexion exercise groups. During the first two consultations, a mobilisation was administered to the mobilisation group. Whereas the craniocervical flexion exercise and a posture correcting exercise were taught to the participants of the craniocervical flexion exercise group. The Numerical Pain Rating Scale, Neck Disability Index, Neck Bournemouth Questionnaire, cervical range of motion and algometer readings were taken at each of the three consultations. The Patient Global Impression of Change Scale was administered at the last consultation one week after the first consultation. Results : Both the mobilisation and craniocervical flexion exercise groups showed significant improvements in all of the subjective outcomes. The Neck Disability Index score of the craniocervical flexion exercise group was the only subjective outcome that did not decrease enough to be considered clinically significant. The PGIC score of the mobilisation group was slightly higher than that of the craniocervical flexion exercise group. There was no statistically significant improvement in the objective outcomes of either group. All ranges of motion decreased in both groups, while pain pressure threshold improved in both groups. There was no significant difference between the results of the subjective and objective outcomes of the mobilisation and craniocervical flexion exercise groups. Conclusions and recommendations : The two interventions were found to have a similar effect in the treatment of chronic non-specific neck pain in terms of subjective and objective outcome measures. Participants of both groups indicated on the subjective scales that their conditions improved, even though objective outcomes showed no significant change. In future studies, a larger sample size should be used and the sample should be stratified for ethnicity to increase validity of the results.

Dissertation completed in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2013. / Background: Mechanical neck pain is a common complaint characterized by pain, limited range of motion and myofascial trigger points. The most common treatments for it are manual therapy and drug therapy. The former includes massage and exercise therapy and more specific to this study spinal manipulation and dry needling. The latter includes non-steroidal anti-inflammatories (NSAIDs) and analgesics. Manipulation assists in increasing range of movement and reduces muscle spasm, while dry-needling inactivates trigger points and decreases local and referred pain. NSAIDs reduce pain and muscle spasm by inhibiting inflammatory pathways. Traumeel®S is a commonly used, safe and well tolerated homoeopathic anti-inflammatory with similar efficacy as NSAIDs but without the adverse gastrointestinal effects. It has also been shown to be highly effective in the treatment of myofascial pain. Methodology: This study was designed as a randomized comparative clinical trial. Fourty participants between ages 18-55 years of age were randomly allocated to two groups of twenty participants each. Group A received spinal manipulation and dry needling in trapezius trigger point two; while Group B received spinal manipulation and Traumeel®S solution injection in trapezius trigger point two. The study took place over a period of two weeks and involved four consultations. Subjective and objective readings were taken at every consultation. Subjective tools included the Numerical pain rating scale (NRS) and Canadian Memorial Chiropractic College (CMCC) neck disability index. Objective tools included the pressure algometer and cervical range of motion (CROM-II) goniometer. SPSS version 20.0 was used in the data analysis. A p-value of <0.05 was considered as statistically significant. Results: The results showed that no statistically significant differences were observed between the two groups in terms of subjective and objective measurements. However, there were statistically significant improvements seen in both groups equally in terms of subjective and objective measurements i.e. both groups showed improvement. Conclusion: The results of this study concluded that the effectiveness of spinal manipulation and dry needling versus spinal manipulation and Traumeel®S Injectable solution in the treatment of mechanical neck pain associated with trapezius myofascial trigger points is equivalent to each other. No statistically or clinically significant changes were noticed between the groups.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background: Musculoskeletal disorders (MSDs) are a significant and common occupational health concern, consequently impacting work attendance and performance. High prevalence rates of MSDs have been reported amongst school teachers. Studies have linked these higher prevalence rates to typical daily teaching activities including prolonged standing, awkward postures, heavy lifting, bending and repetitive movements. Objectives: To determine the prevalence of neck, shoulder and low back pain among primary school teachers in the Central Durban area; to identify any risk factors associated with neck, shoulder and low back pain; and to establish the relationship, if any, between the prevalence and risk factors of neck, shoulder and low back pain among primary school teachers. Methods: This was a quantitative, descriptive and cross-sectional study, conducted in 12 selected public primary schools within the Central Durban area. Volunteers who met the inclusion criteria (n = 97) were invited to complete self-administered questionnaires. Results: Of the 97 completed questionnaires 83.1 percent (%) reported neck and shoulder pain and 71.0% low back pain. Neck and shoulder pain were significantly associated with a forward-bent head posture (p = 0.001), ethnicity (p = 0.001), and history of a severe trauma/injury (p = 0.006). Similarly, significant associations were noted with regards to medical conditions (p = 0.006), a backward-bent head posture (p = 0.016), lifting of heavy loads (p = 0.045) and treatment for severe injury (p = 0.047). Associations were also noted between low back pain and prolonged standing (p = 0.000), ethnicity (p = 0.008), transportation methods (p = 0.023), medical conditions (p = 0.031) and a history of a severe trauma/injury (p = 0.049). Conclusion: This is a first South African study, to our knowledge that highlights increased prevalence rates for both neck and shoulder pain and low back pain amongst teachers, with a variety of associated risk factors. This draws attention to the urgent need for intervention programs to be implemented to prevent/reduce the development of musculoskeletal pain amongst teachers. / M

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic at the Durban University of Technology, 2009. / It has been noted that in many recent research studies mechanical neck pain is a serious problem in the world today. There are epidemiological and statistical studies documenting the high incidence and prevalence of mechanical neck pain, which effects people’s daily living (Drew, 1995; Ferrari and Russell, 2003; Cote et al., 2000, Venketsamy, 2007 and Haldeman et al., 2008). Background: Treatments for chronic neck pain, which are non-surgical, appear to be the most beneficial for patients (Haldeman, 2008). In brief, the presentation of chronic mechanical neck pain is defined as localised, asymmetrical neck pain with restricted range of motion and dysfunctional musculature (Grieve, 1988). The muscular dysfunction known as the upper cross syndrome is defined as tightness of the upper trapezius, pectoralis major and levator scapulae and weakness of rhomboids, serratus anterior, middle and lower trapezius and deep neck flexors. These muscles are responsible for stabilizing the scapula and the patient may present with rounded, elevated shoulders and anterior head carriage when diagnosed with this syndrome (Liebenson, 1996). Clinical trials conducted by Cassidy et al., (1992 a, b) concluded that spinal manipulative therapy (SMT) was highly effective in treating mechanical dysfunctions within the cervical spine. However, due to multi systemic involvement of the muscular, neural and passive systems in mechanical neck pain, the treatment may need to target all three of the subsystems of spinal stability to be most effective (Panjabi, 1992 a, b; Lee et al., 1998; Lee 2004 and Richardson et al., 2002). No research has been conducted on the effects and benefits of treatment directed on the cervical spine and upper cross syndromes. This research will compare scapula stabilization training and SMT to SMT in isolation, as a treatment for chronic mechanical neck pain. Objectives: The purpose of this study was to determine the effect that scapula stabilization had on chronic mechanical neck pain. Pilates exercises were used to strengthen and stabilize the scapula muscles (this included stretching out the hypertonic musculature of the upper cross syndrome). The aim was to improve posture as well as to decrease the mechanical stress on the neck. SMT was also concomitantly used to correct any cervical restrictions that were present. These results were then compared to the results of a group that only received spinal manipulative therapy. The null hypothesis was that the intervention group would not respond differently to the treatment protocol in terms of the subjective and objectives measurements. iv Method: This clinical trial was conducted on a sample population of 30 patients with chronic mechanical neck pain. Each patient was assigned to one of two groups (n=15) according to convenience sampling. Both groups received SMT to the cervical spine, while group B (intervention group) also received pilates classes twice weekly for four weeks, which retrained the scapula stabilization muscles to function optimally. The patients each underwent six spinal manipulative treatments over four weeks and a seventh consultation in the fifth week for data collection. Both groups were evaluated in terms of subjective and objective clinical findings. Subjectively the assessment included 2 questionnaires (Numerical Pain Rating Scale and Canadian Memorial Chiropractic College [CMCC] neck disability index). Objective assessment included cervical motion palpation, Cervical Range Of Motion goniometer (CROM) measurements, scapula stabilization tests and a postural analysis with the use of digital photography. The statistics were completed under the guidance of a biostatistician, from the College of Health Science, University of KwaZulu – Natal, (Esterhuizen, 2008) who analyzed the captured data with the use of SPSS version 15. All outcome measures were quantitative. Repeated measures ANOVA testing was used to assess the presence of a different effect for each outcome measure over time between the two treatment groups. A statistically significant time by group effect would indicate a significant treatment effect. The minimum significance level was 0.05. The trends and direction of the effect were assessed via profile plots. Result: According to the statistical analysis, both groups showed improvements - subjectively and objectively - with regards to chronic mechanical neck pain, which is in keeping with the literature. In terms of the inter-group comparison the SMT group (Group A) showed a more constant improvement in range of motion, pain and disability indexes with the SMT only group while the SMT and pilates group (Group B) showed a greater effect in stabilizing the scapula and increasing the functionality of the surrounding musculature. Conclusions and Recommendations: The intervention treatment (Group B) did not have a greater effect on the short-term treatment of chronic mechanical neck pain than the reference group (Group A). It was also evident that the intervention group (Group B) often continued to improve when the SMT (Group A) only group often regressed at the follow up sessions. This improvement was either not significant enough or v the follow up session did not allow for enough time for a true reflection to be noted. It is recommended that more research be carried out to gain conclusive results indicating whether there is a more beneficial long term result to this treatment protocol.