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September 8, 2026Chiropractic & Manual TherapiesOpen Access

Immediate clinical and neuromechanical effects of cervical spine manipulation compared to cervical spine mobilization among individuals with chronic neck pain: a randomized mechanistic cross-over trial

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Authors

SBSalma BouqartachaDCDanja ConconiYSYves Schwendenmann

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Overview

Randomized cross-over trial finds greater immediate pain relief and muscle response from manipulation over mobilization in chronic neck pain, indicating minimal clinical difference.

Key Points

  • To compare the immediate clinical and neuromechanical effects of cervical spine manipulation versus cervical spine mobilization in individuals with chronic neck pain.
  • Randomized mechanistic cross-over trial enrolling 89 participants with mechanical neck pain across Zurich and Trois-Rivières.
  • Participants received cervical spine manipulation or cervical spine mobilization across two sessions spaced 72 hours apart in randomized sequence.
  • Outcomes included cervical range of motion, pain intensity, grip strength, bilateral pressure pain threshold, and surface electromyography of the sternocleidomastoid, upper trapezius, and tibialis anterior muscles.
  • Pain intensity demonstrated a significant time-by-intervention interaction favoring manipulation (mean decrease: 0.786 NPRS points) over mobilization (mean decrease: 0.373 NPRS points; β = 0.413, 95% CI [0.160, 0.665], p = 0.002).
  • Muscular response was significantly higher following manipulation than mobilization for both sternocleidomastoid (0.144 ± 0.121 vs. 0.023 ± 0.013) and upper trapezius (0.083 ± 0.100 vs. 0.024 ± 0.025) muscles bilaterally.
  • Range of motion and pressure pain thresholds improved across both interventions without significant between-group differences, and statistically significant changes did not reach clinical significance thresholds.

Cite This Study

Bouqartacha et al. (2026) studied this question.

synapsesocial.com/papers/6a9fd7d558e84d0ff5b46f0dhttps://doi.org/10.1186/s12998-026-00674-8
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effectiveness of upper and mid-thoracic spine mobilization in individuals with mechanical neck pain: a randomized control trial2026
  2. 2The impact of spinal manipulation on lumbar proprioception and its link to pain relief: a randomized controlled trial2025
  3. 3Effectiveness of musculoskeletal manipulations in patients with neck pain: a systematic review and network meta-analysis2025 · 4 citations
  4. 4Comparison of Short-Term Effects of Different Spinal Manipulations in Patients with Chronic Non-Specific Neck Pain: A Randomized Controlled Trial2024 · 3 citations
  5. 5Effect of thoracic manipulation on neck pain in the mobility group: A randomized controlled trial2024 · 5 citations