Mobilization versus manipulations versus sustain apophyseal natural glide techniques and interaction with psychological factors for patients with chronic neck pain: randomized controlled trial

48 patients with chronic neck pain were randomized to undergo either high velocity and low amplitude (HVLA) manipulation, anteroposterior mobilization, or sustain apophyseal natural glide treatment. The purpose of this study was to examine the short-term effects of these three manual therapies on pain intensity of neck pain, pressure pain threshold (PPT), and cervical range of motion (CROM). The greatest effect on resting pain scores was observed in the HVLA group, followed by the anteroposterior mobilization group and sustained natural apophyseal glide group. Within group improvement was noted in all three groups for a number of outcomes, including dynamic pain scores, cervical range of motion in lateral flexion and flexion-extension, and pressure pain threshold at C2.