From the British Medical Journal:
As many of us know, neck problems account for considerable pain and stiffness that can lead to work absenteeism, disability and the use of health care resources. Various conservative interventions have been proposed for treating neck pain, but few scientific evaluations have included any analysis of their cost-effectiveness. In this randomized, controlled trial, comparisons are made between the efficacy of manual therapy, physiotherapy and general practitioner care in reducing neck pain. Manual therapy consisted of spinal mobilization focusing on specific muscle mobilization, joint mobilization and coordination and stabilization. Physiotherapy consisted mainly of exercise. General practitioner care consists of counseling, education and analgesics (pain pills).
Outcomes measured included perceived recovery, intensity of pain, functional disability and quality of life; direct and indirect costs were measured to determine the overall cost-effectiveness.
RESULTS: Manual therapy was the most effective of the three treatments, with 68% of the patients demonstrating recovery after seven weeks, compared to 51% in the physiotherapy group and 36% in the general practitioner group. These differences continued to remain significant at 6 months and a year. Manual therapy proved significantly more cost effective than the other two interventions with total costs at one year equaling one-third the costs of either physiotherapy or general practitioner care.