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When mechanical traction is combined with other physical therapy modalities such as passive mobilization, massage, stretching and active exercises, it is an effective treatment for pain reduction in cervical or lumbar spine disorders. [5]
Manual therapy, or manipulative therapy, is a treatment primarily used by physical therapists and occupational therapists to treat musculoskeletal pain and disability. It mostly includes kneading and manipulation of muscles, joint mobilization and joint manipulation .
The International Federation of Orthopaedic Manipulative Physical Therapists defines joint mobilization as "a manual therapy technique comprising a continuum of skilled passive movements that are applied at varying speeds and amplitudes to joints, muscles or nerves with the intent to restore optimal motion, function, and/or to reduce pain." [1]
NAGS involves a mid to end-range facet joint mobilisation applied anterocranially along the plane of treatment within the desired joint, combined with a small amount of manual traction. The purpose of this treatment is to increase movement within the spine, and decrease symptomatic pain.
For neck pain, manipulation and mobilization produce similar changes, and manual therapy and exercise are more effective than other strategies. [12] A 2015 Cochrane systematic review found that there is no high-quality evidence assessing the effectiveness of spinal manipulation for treating neck pain. [13]
Common side effects of spinal manipulative therapy (SMT) are characterized as mild to moderate and may include: local discomfort, headache, tiredness, or radiating discomfort. [ 17 ] Shekelle (1994) summarised the published theories for mechanism(s) of action for how joint manipulation may exert its clinical effects as the following:
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