Long’s manipulation enhances massage for chronic neck pain

By Lucy Piper, Senior medwireNews Reporter

Long's manipulation (LM), a Chinese manipulation approach that incorporates spinal manipulation and traditional Chinese massage (TCM), appears to be more effective for treating chronic mechanical neck pain than massage alone, study findings show.

LM produced greater immediate and short-term pain reduction and superior improvement in patient disability and patient perceived satisfaction compared with TCM.

"However, the Long's manipulation demonstrated no significant benefit for head posture and cervical range of motion," report Thomas Tai Wing Chiu (The Hong Kong Polytechnic University, China) and colleagues in Manual Therapy.

The researchers randomly assigned 63 patients with chronic mechanical neck pain to receive LM or TCM. Each patient received eight 20-minute sessions of therapy every 3 days.

All of the patients received TCM comprising a relaxation step; a reinforcing step involving provocative massage techniques such as pinching, plucking, clapping, and acupressure; and a painful region massage step involving gentle massage techniques applied to the affected region.

The LM patients also received a manipulation step after the relaxation step, which involved the patient's neck being flexed until the tension was palpitated at the targeted level, and then the neck rotated around the axis of the cervical spine to endpoint.

LM was significantly superior to TCM alone in reducing neck disability among the patients, with Northwick Park Neck Pain Questionnaire scores reduced by 23.4% immediately after treatment and 20.4% at 3 months post-treatment. This compared with just 14.7% and 10.3%, respectively, for patients receiving TCM only.

Both groups showed significant improvement in pain relief, but the reduction in pain intensity was greater with LM than TCM alone, with mean scores on the Numeric Pain Rating Scale decreasing by 3.73 points versus 1.59 points immediately following treatment and 3.72 versus 1.09 points at 3 months after treatment.

The greater improvements in disability and pain relief seen with LM meant that patients had significantly greater satisfaction with this treatment than TCM alone.

The researchers now call for additional research of the LM technique that includes a longer follow-up and a "true" controlled group. They also note that "further study is warranted to investigate the effectiveness of Long's manipulation in patients with acute neck pain or whiplash associated disorder."

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