Manual Therapy

Modalities or No Modalities in the Treatment of Neck Pain

As PTs, one criticism we often recieve as a profession is the over-utilization of modalities.  A recent systematic review published in Manual Therapy examined the outcomes of individuals with neck pain treated with manual therapy and with or without modalities.

This article concluded that moderate evidence suggests mobilization, manipulation and soft-tissue techniques decrease pain and improve outcomes when compared to modality driven treatment and that manual techniques paired with exercise produce superior satisfaction.

Evidence in this review also suggests that modalities have little to no effect on satisfaction when paired with manual techniques.  As clinicians, we should be able to justify our use of modalities through the best current evidence, and in the treatment of neck pain, should utilize manual techniques over modalities to improve outcomes.

D’Sylvia J, Miller J, Gross A, et al. Manual Therapy with and without physical medicine modalities for neck pain: a systematic review. Manual Therapy 2010: 15;415-33.


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