Applying Joint Mobilization at Different Cervical Vertebral Levels Does Not Influence Immediate Pain Reduction in Patients with Chronic Neck Pain: A Randomized Clinical Trial

The aim of the present study was to compare the effects of applying joint mobilization at symptomatic and asymptomatic cervical levels in patients with chronic nonspecific neck pain. Forty-eight patients aged between 18 and 65 years and presenting nonspecific neck pain with a minimum duration of 3 months were recruited for the study. Included patients were randomized to one of two treatment groups: (i) control group: the most symptomatic vertebral level was mobilized; (ii) experimental group: a randomly selected vertebral level was chosen and mobilized. All patients received one treatment session. Pain intensity in resting position during the most painful active cervical movement as well as during vertebral palpation was quantified using an 11-point pain scale. Follow-up measures were taken immediately after intervention by a blinded assessor. The results showed no significant difference in pain intensity immediately after treatment between groups (symptomatic level treated vs. randomly chosen cervical vertebral level treated) during resting position, painful active movement, or vertebral palpation. Within-group comparisons showed significant pain relief after treatment during the most painful active movement as well as during vertebral palpation for both groups, but not during resting position. Significant change in immediate pain intensity during painful active movement and vertebral palpation was achieved after vertebral mobilization. however, both groups presented similar pain reductions suggesting that pain reduction due to joint mobilization is not specific to the vertebral level being mobilized.