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Comparative study of hands-on therapy with active exercises vs education with active exercises for the management of upper back pain.

Pesco MS, Chosa E, Tajima N

Department of Occupational Therapy, Kyushu University of Health and Welfare, Nobeoka City, Kyushu, Japan. unkyo31@yahoo.com

OBJECTIVE: The aim of this study was to compare hands-on therapy, including heat, massage, and active exercises with postural education that emphasized increased self-efficacy and postural self-awareness along with education about the physiology of the disorder, and prescribed daily active exercises. SUBJECTS: Twenty-four randomly selected women, 12 custodians and 12 students, with neck and shoulder pain and stiffness. METHODS: All subjects received a medical examination and x-ray before the study to rule out any pre-existing neurologic deficits and an evaluation that included history taking and self-reporting of pain according to a numeric pain scale. Student participants received education and exercise instructions to be continued daily. The custodial workers received once-per-week hands-on treatment. RESULTS: Data were compared using a nonparametric analysis (Wilcoxon signed rank test) and showed evidence of statistically significant reductions in neck, shoulder, and back stiffness and shoulder muscle tension for most of the study subjects. CONCLUSION: Treatment of repetitive stress injuries that combines maintenance of daily active exercises prescribed and modeled by a professional therapist, which emphasize postural awareness to correct poor posture and provide a basic physiological understanding of the disorder, is as crucial to reducing upper back and neck pain and stiffness as hands-on therapy with active exercise provided in a clinical setting.

Published 4 April 2006 in J Manipulative Physiol Ther, 29(3): 228-35.
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