Table 6 Overview of effectiveness of manual therapy treatments

Cervical manipulation as unimodal therapy

More effective at short term follow up (<1 week) on pain than NSAIDs

Low level evidence from 1 study of high methodological quality (Howe, [20]).

Thoracic manipulation as unimodal therapy

Unknown

No RCTs found

Cervical mobilisation as unimodal therapy

More effective at immediate follow up than a placebo or a wait&see policy on pain and range of motion.

Very low level evidence from 1 study of low methodological quality (Brodin, [38]).

Thoracic mobilisations as unimodal therapy

Unknown

No RCTs found

Cervical mobilisation with a neurodynamical intent as unimodal intervention

Immediate increase in elbow extension during an ULNT and a decrease in the area of symptom distribution, and pain intensity.

Low level evidence from 1 study of high methodological quality (Coppieters, [39]).

Combined joint mobilisation and specific (motor control) exercises

More effective at short term follow up (<4 weeks) than either manual therapy or exercise alone or wait & see on pain and activity limitations

Low level evidence from 2 studies, 1 of high (Langevin, [41]) and 1 of low (Ragonese, [18]) methodological quality.

Multimodal intervention with neurodynamic intent

More effective at short term follow up (<4 weeks) than wait & see policy on pain and global perceived effect

Low level evidence from 1 study with of high methodological quality (Nee, [42])

Multimodal intervention with combined (neurodynamic, joint, muscle) intent

More effective at short term (3 - 8 weeks) follow up on pain

Low level evidence from 2 studies of low methodological quality (Ragonese, [18]; Allison, [30])

Cervical traction combined with manual therapy and exercises

At the short term follow up (<4 weeks) no significant difference between traction or placebo traction

Low level evidence from 1 study of high methodological quality (Young, [19])