Combined hands-on therapies ranked highest for neck pain, with uncertain evidence
A network meta-analysis favored combined techniques for pain and disability, but many trials had a high risk of bias and evidence certainty varied.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
Combining musculoskeletal techniques ranked highest for reducing neck pain and disability in this analysis. Several approaches also reduced pain compared with no treatment. However, evidence certainty ranged from moderate to very low, and many trials had a high risk of bias. The ranking does not establish that the combined approach is reliably best for every patient.
The abstract does not report follow-up durations or adverse-event results. Pain measures used different scoring ranges, and the abstract does not explain how those ranges were handled in the pooled estimates.
What the ranking represents
The analysis brought together direct comparisons and indirect evidence across treatments. Combined treatment meant using multiple musculoskeletal techniques. A high ranking describes the ordering within this evidence network; it is not a guarantee of individual benefit.
Different outcomes favored different approaches
Combined techniques ranked highest for pain and neck-related disability, while manipulation ranked highest for forward and backward neck movement. These are separate measured outcomes, so the results do not identify a single winner for everything.
The original publication
Effectiveness of musculoskeletal manipulations in patients with neck pain: a systematic review and network meta-analysis.
Gong Z, Liu W, Gao Y et al.
BMJ Open · 2025
- PubMed ID
- 41083306
- Record checked
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