A study to determine the effectiveness of chiropractic spinal manipulative therapy and/or guided imagery in the treatment of chronic neck pain and stiffness

M. Tech.Objective: This study was conducted in order to compare the effectiveness of Chiropractic spinal manipulative therapy (SMT) combined with guided imagery versus only guided imagery in the treatment of chronic neck pain and stiffness. Chiropractic SMT is aimed at treating neck pain as well as increasing the range of motion (ROM) of the neck. Guided imagery is aimed at reducing stress levels within the patient with a secondary effect of reducing tension in the neck muscles. This study therefore also has a secondary purpose to assess the effects of stress on chronic neck pain. It was hypothesised that Chiropractic SMT combined with guided imagery would be more effective in the reduction of chronic neck pain than guided imagery or alone. This is based on the fact that Chiropractic SMT has been exhaustively proven to be effective in treating chronic neck pain as well as increasing cervical range of motion. Guided imagery has also been proven to be effective in reducing stress even though there has not been enough research on its effect on chronic neck pain and cervical range of motion. Methods: Patients were recruited by means of placing advertisements in and around the University of Johannesburg. Patients that presented to the Chiropractic day clinic with chronic neck pain between the ages of 18 and 30 were included in this study. The participants were then randomly placed in one of two groups. Group A received four sessions of Chiropractic SMT combined with two sessions of guided imagery while Group B received two sessions of guided imagery relaxation techniques and four sessions of detuned ultrasound (U/S). The researcher performed all the sessions of Chiropractic SMT and detuned U/S while Dr A. Fourie (a registered Counselling Psychologist) performed the Guided Imagery sessions. In the initial visit patients in both groups had to undergo a history taking, physical examination and cervical spine regional examination. They were required to sign subject information and consent form and complete a Neck Disability Index (NDI) Questionnaire, Numerical Pain Rating Scale and the Stress Questionnaire. The researcher measured their cervical range of motion on the first and last treatments. The objective and subjective data was collected on the first visit and again on the final visit