Chiropractic manipulative therapy and low-level laser therapy in the management of cervical facet dysfunction: a randomized controlled study.

摘要

PURPOSE: The aim of this study was to determine the short-term effect of chiropractic joint manipulation therapy (CMT) and low-level laser therapy (LLLT) on pain and range of motion in the management of cervical facet dysfunction. METHODS: Sixty ambulatory women between the ages of 18 and 40 years with cervical facet joint pain of more than 30-day duration and normal neurologic examination were randomized to receive 1 of 3 treatment options: (1) CMT of the cervical spine, (2) LLLT applied to the cervical facet joints, or (3) a combination of CMT and LLLT. Each participant received 6 treatments in 3 weeks. The main outcome measures were as follows: the Numerical Pain Rating Scale, Neck Disability Index, Cervical Range of Motion Instrument, and Baseline Digital Inclinometer. Measurements were taken during weeks 1 (baseline), 2, 3, and 4. RESULTS: No differences existed between the 3 groups at baseline. A significant difference was seen between groups 1 (CMT) and 2 (LLLT) for cervical flexion, between groups 1 (CMT) and 3 (CMT + LLLT) for cervical flexion and rotation, and between groups 2 (LLLT) and 3 (CMT + LLLT) for pain disability in everyday life, lateral flexion, and rotation. CONCLUSION: All 3 groups showed improvement in the primary and secondary outcomes. A combination of CMT and LLLT was more effective than either of the 2 on their own. Both therapies are indicated as potentially beneficial treatments for cervical facet dysfunction. Further studies are needed to explore optimal treatment procedures for CMT and LLLT and the possible mechanism of interaction between therapies.