Ensayo clínico aleatorizado en pacientes con cervicalgiamecá nica en atencion primaria: Terapia manual frente a electroestimulación nerviosa transcutánea

Abstract

Objective. To compare the effectiveness of manual therapy (MT) versus transcutaneous electrical nervous stimulation (TENS) in reducing the intensity of pain in patients with subacute or chronic neck pain (NP) attended at primary care physiotherapy units (PCPU). Design. Randomised clinical trial. Setting. Thirteen PCPU in 4 health districts of the Community of Madrid, Spain. Participants. Ninety patients with subacute or chronic NP attended. Lost after intervention: 3. Interventions. At random, 47 patients were allocated to MT treatment and 43 to TENS. Main measurements. Social and demographic characteristics and prognosis variables in the intervention groups were measured. Intensity of pain before and after intervention was calculated by mean values on the analogue visual scale (present moment, average and worst pain of the last 2 weeks). Side-effects were also measured. Results. Difference between befbre-and-after pain was 21.83 mm (95% CI, 13.71-29.95) for the group treated with Transcutaneous electrical nervous stimulation and 22.87 mm (95% CI, 17.11-28.64) for manual therapy. The difference in averages on comparing the 2 procedures for improvement was 1.04 (95% CI,-8.66% to 10.75%). Conclusions. TENS and MT significantly reduce patients' perceived intensity of pain, although there were no differences between the 2 groups. There are no conclusive results for the alternative physiotherapy treatments that determine a clear strategy of intervention.