OBJECTIVE: To assess whether Chinese manipulation improves pain, function/disability and global perceived effect in adults with acute/subacute/chronic neck pain. DATA SOURCES: CAJ Full-text Database (Chinese), Wanfang Database (Chinese), Cochrane Database (English) and Medline (English). REVIEW METHODS: Literature searching was performed with the following keywords and their combination: 'manual therapy/bone setting/Chinese manipulation', 'neck/cervical pain', 'cervical vertebrae', 'cervical spondylosis/radiculopathy' and 'randomized controlled trial/review'. Two independent reviewers selected studies, extracted data and assessed risk of bias for each included study. Randomized controlled trials or quasi-randomized controlled trials on the effect of Chinese manipulation in treating adult patients with neck pain were selected. Mean differences with 95% confidence intervals (CI) were calculated. Quality of the evidence was assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. RESULTS: Four studies (610 participants) were included in this review. There was very low-quality evidence suggesting that, compared to cervical traction in sitting, Chinese manipulation produced more immediate post-intervention pain relief (mean difference -1.06; 95% CI -1.37 to -0.75; p < 0.001) and improvement of global signs and symptoms (mean difference -3.81; 95% CI -4.71 to -2.91; p < 0.001). Very low-quality evidence showed that Chinese manipulation alone was superior to Chinese traditional massage in immediate post-intervention pain relief (mean difference -2.02; 95% CI -2.78 to -1.26; p < 0.001). CONCLUSIONS: There was limited evidence showing Chinese manipulation could produce short-term improvement for neck pain.

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