M.Tech. (Chiropractic) / Mechanical neck pain is the general term that refers to any type of pain within the cervical spine caused by placing abnormal stress and strain on muscles of the vertebral column. This is a very common musculo-skeletal disorder within the population, with 45% to 54% reporting neck pain at any given time of their lives (Martinez-Segura, Fernandez-de-las-Penas, Ruiz-Saez, Lopez-Jimenez and Rodriguez-Blanco, 2006). A vast majority of individuals do not experience a complete resolution of symptoms and as such often becomes a chronic pain (Cote, Cassidy, Carol and Kristman, 2004). Chronic pain by definition is one which is present for a period longer than six weeks (Segen, 2002). Accompanying the neck pain is often a limited or reduced range of motion within the cervical spine. Some studies suggest that hyper-tonicity and strain of the supporting muscles within this region due to an altered biomechanics also contributes to the pain and dysfunction (Armstrong, McNair and Williams, 2005 and Dall’Alba et al. 2001). One of the major muscle groups involved in this is the posterior cervical musculature. This is a general term used to describe the muscles located on the posterior aspect of the neck and includes longissimus capitis, semispinalis capitis, semispinalis cervicis, rotatores and multifidus (Dalley and Moore, 2006). Chiropractic adjustment therapy has been shown to have many effects of the body and especially the cervical spine including a decrease in pain perception and muscle hypertonicity (Kirkaldy-Willis and Cassidy, 1985), an increase in cervical range of motion (Bergmann, Peterson and Lawrence, 1993) as well as an increased skin pain tolerance level (Terrett and Vernon, 1984). Dry needling therapy has also been proven to have similar effects, including, a reduction in pain perception, an increase in range in motion of the specific linked biomechanical section, and most importantly a reduction of muscle tension (Travell and Simons, 1993). The purpose of this study was to see if a synergistic effect of the two above mentioned treatments would occur when combined under one treatment protocol. The aim of this study was to determine how effectively cervical adjustment therapy, dry needling of the posterior cervical muscles and a combination of the two treatments was in treating chronic mechanical neck pain with regards to pain, disability and cervical spine range of motion over a three week period. 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 word of mouth as well as with the use of advertisements that were placed around the respective campuses of the University of Johannesburg. Thirty participants who presented with chronic mechanical neck pain, volunteered for this comparative study. This trial is a randomised controlled clinical trial which used convenience sampling. Group A received a combination treatment of dry needling and cervical manipulation. Group B received cervical adjustment only while group C received dry needling of the posterior cervical musculature alone. participants were treated for a total of 6 visits. Subjective and objective measurements were done at visits 1, 4 and a final visit 7 during which only measurements were taken. These effects are based on Vernon-Mior Pain and Disability Index, Numerical Pain Scale Rating, Pressure Algometer as well as Cervical Spine Range of Motion measuring instrument (CROM). The results of this trial indicated that all three treatments were effective in treating chronic mechanic neck pain. While one treatment was not statistically more effective than the other the dry needling and cervical manipulation alone produced a superior result. While combining these treatments was effective the synergistic effect one would expect was not as evident.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uj/uj:4565 |
| Date | 01 April 2014 |
| Creators | Cooper, Jacqueline Lynette |
| Source Sets | South African National ETD Portal |
| Detected Language | English |
| Type | Thesis |
| Rights | University of Johannesburg |
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