Effectiveness and safety of manual therapy for inpatients with traffic accident-induced acute neck pain: A randomized controlled trial

BACKGROUND: Research on the benefits of mobilization-focused manual therapy for whiplash syndrome is needed. OBJECTIVE: This study evaluated the effectiveness of manual therapy as an adjunct to integrative Korean medicine treatment (IKMT) for acute neck pain following traffic accidents. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: A single-center, two-arm, assessor-blinded, randomized clinical trial was conducted between 20 November 2020 and 26 July 2022. This study included 120 patients with acute neck pain after a traffic accident. IKMT was performed in the intervention and control groups during hospitalization. The intervention group also underwent four mobilization-focused manual therapy sessions. MAIN OUTCOME MEASURES: The primary outcome was a change from the baseline in the numeric rating scale of neck pain on day 5 of hospitalization. RESULTS: A total of 120 participants were allocated to two groups (60 patients each), and the modified intention-to-treat analysis set included 60 and 59 patients in the intervention and control groups, respectively. On day 5, the intervention group showed more improvement in numeric rating (by 0.97 [0.38, 1.57]) and visual analogue (by 9.84 [4.15, 15.54]) scale scores, compared to the control group. The area under the curve of cumulative values up to day 5 was smaller in the intervention group than in the control group, with numeric rating and visual analogue scale scores of 2.81 (1.33, 4.29) and 31.02 (15.81, 46.22), respectively. CONCLUSION: Administration of manual therapy as an adjunct to IKMT among patients with traffic accident-induced acute neck pain resulted in faster and better improvement in neck pain up to day 5 compared to IKMT alone. However, the outcomes showed no significant differences at the 12-week follow-up. TRIAL REGISTRATION: ClinicalTrials.gov (NCT04660175). Please cite this article as: Choi SW, Kim KH, Yoon JY, Lee SW, Park JW, Hong HW, Kyeong DH, Kim MK, Kim SN, Kim CY, Lee YJ, Lee JH, Kim JY, Ha IH. Effectiveness and safety of manual therapy for inpatients with traffic accident-induced acute neck pain: A randomized controlled trial. J Integr Med. 2026; 24(1):81-89.