Trial reportEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2016
Cost-effectiveness of manual therapy versus physiotherapy in patients with sub-acute and chronic neck pain: a randomised controlled trial.
Trial report in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00713843 (Effectiveness of Manual Therapy and Physical Therapy in Patients With Subacute and Chronic Non-specific Neck Pain. A Randomized Controlled Trial.), which is not on this map. Cited by 16 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effectiveness of Manual Therapy and Physical Therapy in Patients With Subacute and Chronic Non-specific Neck Pain. A Randomized Controlled Trial.
Who cites it
16 citing papers in PubMed, 5 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Cost-effectiveness of spinal manipulation, exercise, and self-management for spinal pain.Chiropractic & manual therapies · 2025Pooled it
- Efficacy and safety of spinal manipulative therapy in the management of acute neck pain: a systematic review and meta-analysis.Systematic reviews · 2025Pooled it
- The majority of clinical trials assessing mobilization and manipulation for neck pain lack a pragmatic approach: a systematic review of 174 trials.The Journal of manual & manipulative therapy · 2024Pooled it
- Cost-Effectiveness of Treatments for Musculoskeletal Conditions Offered by Physiotherapists: A Systematic Review of Trial-Based Evaluations.Sports medicine - open · 2024Pooled it
- Massage for neck pain.The Cochrane database of systematic reviews · 2024Pooled it
- Efficacy and safety of Shi's cervical manipulation versus diclofenac for patients with acute and subacute neck pain: a multicenter clinical randomized trial.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2025Trial
- An economic evaluation of pharmacopuncture versus usual care for chronic neck pain: a pragmatic randomized controlled trial.BMC health services research · 2023Trial
- Chuna Manual Therapy vs Usual Care for Patients With Nonspecific Chronic Neck Pain: A Randomized Clinical Trial.JAMA network open · 2021Trial
- Economic Evaluation of Pharmacopuncture for Adhesive Capsulitis Alongside a Pilot Pragmatic Randomized Controlled Trial Comparing Pharmacopuncture and Physical Therapy.Healthcare (Basel, Switzerland) · 2026Article
- A modern way to teach and practice manual therapy.Chiropractic & manual therapies · 2024Review
- Cost-Utility Analysis of Chuna Manual Therapy and Usual Care for Chronic Neck Pain: A Multicenter Pragmatic Randomized Controlled Trial.Frontiers in medicine · 2022Article
- 'Next steps' for researching orthopedic manual therapy.The Journal of manual & manipulative therapy · 2021Article
- Cost-effectiveness of direct discharge from the emergency department of patients with simple stable injuries in the Netherlands.Trauma surgery & acute care open · 2021Article
- Article
- Manual therapy compared with physical therapy in patients with non-specific neck pain: a randomized controlled trial.Chiropractic & manual therapies · 2017Article
- Pain and Vertebral Dysfunction in Dry Immersion: A Model of Microgravity Simulation Different from Bed Rest Studies.Pain research & management · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate the cost-effectiveness of manual therapy according to the Utrecht School (MTU) in comparison with physiotherapy (PT) in sub-acute and chronic non-specific neck pain patients from a societal perspective.
methodsAn economic evaluation was conducted alongside a 52-week randomized controlled trial, in which 90 patients were randomized to the MTU group and 91 to the PT group. Clinical outcomes included perceived recovery (yes/no), functional status (continuous and yes/no), and quality-adjusted life-years (QALYs). Costs were measured from a societal perspective using self-reported questionnaires. Missing data were imputed using multiple imputation. To estimate statistical uncertainty, bootstrapping techniques were used.
resultsAfter 52 weeks, there were no significant between-group differences in clinical outcomes. During follow-up, intervention costs (β:€-32; 95 %CI: -54 to -10) and healthcare costs (β:€-126; 95 %CI: -235 to -32) were significantly lower in the MTU group than in the PT group, whereas unpaid productivity costs were significantly higher (β:€186; 95 %CI:19-557). Societal costs did not significantly differ between groups (β:€-96; 95 %CI:-1975-2022). For QALYs and functional status (yes/no), the maximum probability of MTU being cost-effective in comparison with PT was low (≤0.54). For perceived recovery (yes/no) and functional status (continuous), a large amount of money must be paid per additional unit of effect to reach a reasonable probability of cost-effectiveness.
conclusionsFrom a societal perspective, MTU was not cost-effective in comparison with PT in patients with sub-acute and chronic non-specific neck pain for perceived recovery, functional status, and QALYs. As no clear total societal cost and effect differences were found between MTU and PT, the decision about what intervention to administer, reimburse, and/or implement can be based on the preferences of the patient and the decision-maker at hand.
trial registrationClinicalTrials.gov Identifier: NCT00713843.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.