Abstract
M. Tech.
Objective: This study was conducted in order to compare the effectiveness of Chiropractic
spinal manipulative therapy (SMT) combined with guided imagery versus only guided
imagery in the treatment of chronic neck pain and stiffness. Chiropractic SMT is aimed at
treating neck pain as well as increasing the range of motion (ROM) of the neck. Guided
imagery is aimed at reducing stress levels within the patient with a secondary effect of
reducing tension in the neck muscles. This study therefore also has a secondary purpose to
assess the effects of stress on chronic neck pain.
It was hypothesised that Chiropractic SMT combined with guided imagery would be more
effective in the reduction of chronic neck pain than guided imagery or alone. This is based on
the fact that Chiropractic SMT has been exhaustively proven to be effective in treating
chronic neck pain as well as increasing cervical range of motion. Guided imagery has also
been proven to be effective in reducing stress even though there has not been enough research
on its effect on chronic neck pain and cervical range of motion.
Methods: Patients were recruited by means of placing advertisements in and around the
University of Johannesburg. Patients that presented to the Chiropractic day clinic with chronic
neck pain between the ages of 18 and 30 were included in this study. The participants were
then randomly placed in one of two groups. Group A received four sessions of Chiropractic
SMT combined with two sessions of guided imagery while Group B received two sessions of
guided imagery relaxation techniques and four sessions of detuned ultrasound (U/S). The
researcher performed all the sessions of Chiropractic SMT and detuned U/S while Dr A.
Fourie (a registered Counselling Psychologist) performed the Guided Imagery sessions.
In the initial visit patients in both groups had to undergo a history taking, physical
examination and cervical spine regional examination. They were required to sign subject
information and consent form and complete a Neck Disability Index (NDI) Questionnaire,
Numerical Pain Rating Scale and the Stress Questionnaire. The researcher measured their
cervical range of motion on the first and last treatments. The objective and subjective data
was collected on the first visit and again on the final visit.