PURPOSE: This study compared the relative efficacy of posterior-anterior unilateral pressure (PAUP), anterior-posterior unilateral pressure (APUP), cervical oscillatory rotation (COR) and transverse oscillatory pressure (TOP) techniques of manual therapy in the management of unilateral cervical spondylosis. SUBJECTS AND METHODS: Twenty-four male subjects in each of four groups (96 patients; age range 40 to 50 years, mean 44 +/- 5.3 years) received treatment 3 times per week for four weeks. Mean treatment time, pain recovery pattern (pain-free, residual pain, fair improvement, no change or worse) and relapse after 3 months were outcome measures. RESULTS: Significantly (p < 0.001) less time was spent applying APUP (130 min) and PAUP (156 min) than COR (192 min) and TOP (219 min) with significantly (p < 0.001) more pain-free patients in APUP (63%) and PAUP (46%) groups than in COR (17%) and TOP (25%) groups. Relapse rates after 3 months were 8% (TOP) and 12% (COR) and these treatments had no effect on symptoms of 4% and 8% of patients, respectively. CONCLUSION: APUP and PAUP achieve faster pain relief in more patients with unilateral cervical spondylosis than rotation and transverse pressure. Unilateral pressures should be preferred techniques of manual therapy for patients with unilateral neck pain and APUP promise a better outcome.

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