The Somatic Connection  |   July 2018
Effect of HVLA on Chronic Neck Pain and Dysfunction
Author Notes
  • Western University of Health Sciences College of Osteopathic Medicine of the Pacific, Pomona, California 
Article Information
The Somatic Connection   |   July 2018
Effect of HVLA on Chronic Neck Pain and Dysfunction
The Journal of the American Osteopathic Association, July 2018, Vol. 118, 483-484. doi:10.7556/jaoa.2018.104
The Journal of the American Osteopathic Association, July 2018, Vol. 118, 483-484. doi:10.7556/jaoa.2018.104
Galindez-Ibarbengoetxea X, Setuain I, Ramírez-Vélez R, et al. Immediate effects of osteopathic treatment versus therapeutic exercise on patients with chronic cervical pain. Altern Ther Health Med. 2017;23(7):238-246. 
Neck pain is the third-most common chronic pain condition in the United States associated with long-term pain medication use.1 A 2005 American Osteopathic Association Position Paper supported cervical manipulation as a safe and efficacious alternative treatment.2 Despite this position paper, there is insufficient evidence to determine the effectiveness of high-velocity, low-amplitude (HVLA) manipulation vs craniocervical flexion (CCF) exercises in improving chronic neck pain. 
Physiotherapists in Spain evaluated HVLA in relation to CCF exercises through measuring pain using a visual analog scale (VAS), cervical range of motion (ROM), and electromyographic activation of the sternocleidomastoid at baseline and 60 seconds after intervention. Twenty-five patients were randomly assigned to the manual therapy (MT) group (n=12) or CCF group (n=13). They were aged between 18 to 50 years, with a mean (SD) age of 31.3 [1.8] years in the MT group and 34.0 (1.8) years in the CCF group. Patients had a history of neck pain for at least 3 months, pain intensity of at least 25/100 on VAS during ROM, and somatic dysfunction in the temporomandibular joint, cervical, and thoracic regions. Exclusion criteria were craniocervical trauma; neurologic alterations in limbs or the central nervous system; injury to a vertebral disk; degenerative, rheumatologic, or inflammatory pathologic processes; pregnant; operation on or fracture of cervical spine; or “a positive test” on vertebral artery evaluation. 

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