In 2001 The Duke Evidence Report stated:
"Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache".
In 2003 the British Medical Journal published the results of a randomized controlled trial:
183 patients with neck pain were randomly allocated to manual therapy (spinal mobilization), physiotherapy (mainly exercise) or general practitioner care (counseling, education and drugs) in a 52- week study.
The clinical outcomes measure showed that manual therapy resulted in faster recovery than physiotherapy and general practitioner care. Moreover, total costs of the manual therapy-treated patients were about one third of the costs of physiotherapy or general practitioner care.
In 2002 in the Annals of Internal Medicine:
"In our randomized, controlled trial, we compared the effectiveness of manual therapy, physical therapy, and continued care by a general practitioner in patients with nonspecific neck pain. The success rate at seven weeks was twice as high for the manual therapy group (96.3 percent) as for the continued care group (general practitioner). Manual therapy scored better that physical therapy on all outcome measures. Patients receiving manual therapy had fewer absences from work that patients receiving physical therapy or continued care, and manual therapy and physical therapy each resulted in statistically significant less analgesic use than continued care."
