Table 5

Evidence for neck pain

ComparatorQualityPopulation sizeComplementary medicineSafetyCost-effectiveness
Active interventionGoodMediumManual therapy87*Some evidence of potential harm82 83Some evidence of CE87 88
ModerateLargeManipulation82§¶Some evidence of potential harm82 83Some evidence of CE87 88
ModerateSmallManual therapy88**Some evidence of potential harm82 83Some evidence of CE87 88
PlaceboModerateMediumAcupuncture89 Some evidence of safety89 No data40
Usual careModerateMediumAcupuncture89 Some evidence of safety89 No data40
  • *Manual therapy plus exercise compared with exercise alone.

  • †Reduced cost of therapy.

  • ‡Minor adverse events and rare but devastating adverse effects from manipulation.

  • §Compared to medication.

  • ¶Also showed effectiveness for pain compared with any control.

  • **Mobilisation, manipulation and soft tissue techniques.

  • CE, cost effectiveness.