The Pros and Cons of Passive Physical Therapy Modalities for Neck Disorders

Objectives

To present the pros and cons of passive physical therapy modalities, on the basis of the existing body of evidence, for the management of neck disorders namely whiplashassociated disorders and all other nonspecific neck disorders and complaints.

Findings

The existing body of evidence on effectiveness is extremely disappointing. Only a handful of studies have met minimal methodological standards in the field of physiotherapy, including medicine and surgery. Of all passive physical therapy modalities only mobilization/manipulation have shown some evidence of effectiveness.

Conclusions

The long list of passive physical therapy modalities must be drastically shortened. The impression that manual therapy and physiotherapy may be more efficacious than medicine in the management of neck disorders may be explained by the patient's desire for a more “holistic approach” which includes personal and physical contact. The cons of passive modalities are that they may lead to patient's passivity, inactivity and disability behavior. The126pros are that they provide a “unique occasion” to reassure the patient and to remind him/her about the necessity of keeping active and staying at work as long as it does not further “ harm” the neck condition. [Article copies available from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@ihaworth.com]