Evidence map›Paper›PMID 38627846›Full record

ReviewBMC sports science, medicine & rehabilitation2024

Effectiveness and safety of manual therapy when compared with oral pain medications in patients with neck pain: a systematic review and meta-analysis.

Joshua Makin, Lauren Watson, Dimitra V Pouliopoulou, Taylor Laframboise, Bradley Gangloff, Ravinder Sidhu, Jackie Sadi, Pulak Parikh, Anita Gross, Pierre Langevin and 2 more

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BMC sports science, medicine & rehabilitation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.7field-weighted citation impact, top 11% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 2 countries.

Joshua Makin *Comprehensive Musculoskeletal Field, Advanced Health Care Program, School of Physical Therapy, Western University, London, ON, Canada.
Lauren Watson *Comprehensive Musculoskeletal Field, Advanced Health Care Program, School of Physical Therapy, Western University, London, ON, Canada.
Dimitra V PouliopoulouSchool of Physical Therapy, Health and Rehabilitation Sciences, Western University, London, ON, Canada.
Taylor LaframboiseComprehensive Musculoskeletal Field, Advanced Health Care Program, School of Physical Therapy, Western University, London, ON, Canada.
Bradley GangloffComprehensive Musculoskeletal Field, Advanced Health Care Program, School of Physical Therapy, Western University, London, ON, Canada.
Ravinder SidhuComprehensive Musculoskeletal Field, Advanced Health Care Program, School of Physical Therapy, Western University, London, ON, Canada.
Jackie SadiComprehensive Musculoskeletal Field, Advanced Health Care Program, School of Physical Therapy, Western University, London, ON, Canada.
Pulak ParikhComprehensive Musculoskeletal Field, Advanced Health Care Program, School of Physical Therapy, Western University, London, ON, Canada.
Anita GrossSchool of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada.
Pierre LangevinSchool of Rehabilitation Sciences, Université Laval, Quebec City, QC, Canada.
Heather GillisComprehensive Musculoskeletal Field, Advanced Health Care Program, School of Physical Therapy, Western University, London, ON, Canada.
Pavlos BobosComprehensive Musculoskeletal Field, Advanced Health Care Program, School of Physical Therapy, Western University, London, ON, Canada. pbobos@uwo.ca.
Western University · CAActive Technologies (Italy) · ITMcMaster University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis systematic review and meta-analysis seeks to investigate the effectiveness and safety of manual therapy (MT) interventions compared to oral pain medication in the management of neck pain.

methodsWe searched from inception to March 2023, in Cochrane Central Register of Controller Trials (CENTRAL), MEDLINE, EMBASE, Allied and Complementary Medicine (AMED) and Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO) for randomized controlled trials that examined the effect of manual therapy interventions for neck pain when compared to medication in adults with self-reported neck pain, irrespective of radicular findings, specific cause, and associated cervicogenic headaches. We used the Cochrane Risk of Bias 2 tool to assess the potential risk of bias in the included studies, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach to grade the quality of the evidence.

resultsNine trials (779 participants) were included in the meta-analysis. We found low certainty of evidence that MT interventions may be more effective than oral pain medication in pain reduction in the short-term (Standardized Mean Difference: -0.39; 95% CI -0.66 to -0.11; 8 trials, 676 participants), and moderate certainty of evidence that MT interventions may be more effective than oral pain medication in pain reduction in the long-term (Standardized Mean Difference: - 0.36; 95% CI - 0.55 to - 0.17; 6 trials, 567 participants). We found low certainty evidence that the risk of adverse events may be lower for patients that received MT compared to the ones that received oral pain medication (Risk Ratio: 0.59; 95% CI 0.43 to 0.79; 5 trials, 426 participants).

conclusionsMT may be more effective for people with neck pain in both short and long-term with a better safety profile regarding adverse events when compared to patients receiving oral pain medications. However, we advise caution when interpreting our safety results due to the different level of reporting strategies in place for MT and medication-induced adverse events. Future MT trials should create and adhere to strict reporting strategies with regards to adverse events to help gain a better understanding on the nature of potential MT-induced adverse events and to ensure patient safety.

trial registrationPROSPERO registration number: CRD42023421147.

Indexed as

EffectivenessManual therapyMeta-analysisNeck painSafetySystematic review

Identifiers

PMID38627846
PMCPMC11020448
OpenAlexW4394856116

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.