Abstract
M.Tech. (Chiropractic)
Introduction: The most common chronic pain condition in modern society is neck pain (Jensen and Harms-Ringdahl, 2007). Chronic neck pain is a common complaint for many, from young patients to older patients with stressful work situations. According to Graham, Gross and Goldsmith (2006) neck disorders are common, disabling to various degrees and costly. Various structures in the cervical spine capable of transmitting pain include facet joints, intervertebral discs, nerve root dura, ligaments, and muscles (Manchikanti, Singh, Rivera and Pampati, 2002).
According to Rochester (2009) chiropractors treat patients with chronic neck pain by using spinal manipulative therapy (SMT) to address a segmental joint hypomobility within the cervical spine as determined by joint motion palpation and endplay assessment.
Traction is commonly used for the treatment of the spine by various physical therapists. It may be included as part of a chiropractic treatment protocol. According to Hooper (1996) traction involves the application of both manual and mechanical forces to draw adjacent body parts away from each other resulting in decompressed irritated tissues, realign parts, and relaxing tight structures. There are several types of cervical traction. The short and medium term improvement for chronic neck pain as well as the comparative effect of manual cervical traction versus mechanical cervical traction in combination with spinal manipulative therapy has not yet been established.
Aim: This particular research study aimed to compare the short to medium term efficacy of manual cervical traction with mechanical cervical traction combined with spinal manipulative therapy with regards to decreased pain and improvement of cervical spine ranges of motion in patients with chronic neck pain. Methodology: Participants who met the inclusion and exclusion criteria were eligible to participate in this study. Advertisements were placed on notice boards around the campus of the University of Johannesburg and participants were recruited from the use of advertisements as well as word of mouth to partake in this research study.
Thirty participants who suffered from chronic neck pain, volunteered for this comparative research study. This study was a randomized comparative study, where participants were randomly selected to be either in Group 1 or in Group 2. Group 1 received manual cervical traction whereas Group 2 received mechanical cervical traction. Both groups received spinal manipulative therapy to the restricted motion segments found in the cervical spine. Participants received seven trial sessions, with six treatments, over a period of two weeks. At the final 7th visit, one month after the sixth visit, no treatment was performed. Subjective and objective measurements were recorded at each visit.
The subjective measurements of this particular study consisted of the Numerical Pain Rating Scale (NPRS) and the Vernon-Mior Neck Disability Index to evaluate the participants’ sensitivity to pain and disability. The objective measurements of this study included the Cervical Spine Range of Motion instrument to assess the participants’ cervical spine movement.
Results: Both groups demonstrated a statistically significant improvement over time with regards to pain and disability, as well as increased range of motion to the cervical spine. The greatest percentage improvement with regards to range of motion was in lateral flexion and rotation of the cervical spine.
Conclusion: According to the results of this study, it could be concluded that either manual cervical traction or mechanical cervical traction in combination with spinal manipulative therapy can be used effectively in the treatment of chronic neck pain as part of a chiropractic treatment protocol. Both groups proved to have a statistically significant improvement with regards to pain and disability as well as increased cervical spine range of motion...