Each year, nearly 1-in-4 women and 1-in-6 men experience an episode of neck pain. In particular, the risk is highest for working-age adults aged 30 to 59 years. Interestingly, past research suggests that indirect costs associated with a condition like neck pain—such as missing work or lost productivity—often exceed direct healthcare expenditures. Thus, when it comes to a recommended course of care, it’s important for care to improve pain and function so that the patient can return to work, with a reduced risk for relapse or recurrence of their neck pain.

In a May 2022 study, researchers reported that prior research has found that manual therapies for neck pain management often produce better outcomes and are more cost effective than both specialist care and physical therapy. However, little research exists that directly compares a multimodal manual therapy-based approach with physician-delivered advice on how to cope with pain and to stay active.

The research team recruited working-aged adults with neck pain and split them into two groups. The first group received six treatments spread over six weeks that included spinal manipulation, mobilization, massage, and stretching—all treatments a patient may experience in a chiropractic office. Participants in the second group visited with a physician two times three weeks apart and received instruction on ways to stay active and how to cope with pain.

Over the course of the next year, participants completed outcome questionnaires used to determine health-related quality of life (physical functioning, bodily pain, general health, vitality, social functioning, mental health, etc.). The researchers also asked the participants in each group about what additional care they used to manage their pain following the conclusion of the treatment period and if they had used any sick days due to their pain in that time.

Subsequent analysis showed that not only did participants in the manual therapy group report greater improvement in health-related quality of life, but the overall cost per patient in direct and indirect costs was 49% lower. Interestingly, the research team found that patients in the manual therapy group were also two-times less likely to require more intensive, costly care. The authors summarized their finding: “The results indicate that manual therapy achieves better outcomes at lower costs compared with advice to stay active.”

Doctors of chiropractic often manage patients with neck pain using a multimodal approach that incorporates the manual therapies used in this study in addition to specific exercise advice, nutritional counseling, and physiotherapy modalities, all dependent on their clinical experience and the patient’s unique case.