top of page

Chuna Manual Therapy vs Usual Care for Patients With Nonspecific Chronic Neck Pain: A Randomized Clinical Trial


Full Text Link

Randomized Controlled Trial, Clinical trial


Osteopathic Manipulative Treatment

JAMA Netw Open. 2021 Jul 1;4(7):e2113757.


Jinho Lee  , Jae-Heung Cho  , Koh-Woon Kim  , Jun-Hwan Lee  , Me-Riong Kim  , Joowon Kim  , Min-Young Kim  , Hyun-Woo Cho  , Yoon Jae Lee  , Sook-Hyun Lee  , Joon-Shik Shin  , Lawrence L Prokop  , Byung-Cheul Shin , In-Hyuk Ha 


Importance: The incidence rate of neck pain is increasing worldwide, and the disease is associated with a high social burden. Manual therapy has been widely applied in the treatment of neck pain, but a high-quality, pragmatic randomized clinical trial for this treatment has not been conducted to date.

Objective: This study aimed to compare the effectiveness of Chuna manual therapy with that of usual care for patients with chronic neck pain.

Design, setting, and participants: A multicenter, assessor-blinded, pragmatic, randomized clinical trial was conducted between October 18, 2017, and June 28, 2019. This intention-to-treat analysis included 108 patients with chronic neck pain persisting for at least 3 months; patients were recruited from 5 hospitals in Korea.

Interventions: Ten sessions (2 sessions per week for 5 weeks) of Chuna manual therapy or usual care (electrotherapy and oral medication) were conducted.

Main outcomes and measures: The main outcome was the difference in visual analog scale (VAS) score for chronic neck pain between baseline and 5 weeks after randomization.

Results: This randomized clinical trial recruited 108 patients (mean [SD] age, 38.4 [9.3] years; 73 women [67.6%]). Fifty-four patients were allocated to the Chuna therapy group, and 54 received usual care. At 5 weeks after randomization, manual therapy showed statistically superior results compared with usual care in terms of pain (difference in chronic neck pain VAS, 16.8 mm; 95% CI, 10.1-23.5 mm), function (difference in Neck Disability Index, 8.6%; 95% CI, 4.2%-13.1%), and quality of life (difference in the European Quality of Life-5 Dimension 5 Levels (EQ-5D-5L) scores, -0.07 points; 95% CI, -0.11 to -0.02 points). Regarding the 1-year cumulative values measured using area under the curve analyses, superior outcomes were attained in the manual therapy group in terms of the numerical rating scale for chronic neck pain (1.3 points; 95% CI, 0.5-2.0 points), Neck Disability Index (6.7%; 95% CI, 2.5%-10.9%), Neck Pain Questionnaire (7.4%; 95% CI, 2.3%-12.6%), and EQ-5D-5L scores (-0.03 points; -0.07 to 0.00 points).

Conclusions and relevance: In this randomized clinical trial, for patients with chronic neck pain, Chuna manual therapy was more effective than usual care in terms of pain and functional recovery at 5 weeks and 1 year after randomization. These results support the need to consider recommending manual therapies as primary care treatments for chronic neck pain.

Publication Date: 

2021 Jul



Lee, J., Cho, J., Kim, K., Lee, J., Kim, M., Kim, J., Kim, M., Cho, H., Lee, JY., Lee, S., Shin, J., Prokop, LL., Shin, B., Ha, I. (2021) 'Chuna Manual Therapy vs Usual Care for Patients With Nonspecific Chronic Neck Pain: A Randomized Clinical Trial ', JAMA Netw Open. 2021 Jul 1;4(7):e2113757.

Sponsored by 


Search    Explore    About    Join    Web Policy     Contact Us

Copyright © 2023 OsteoEvidence. All Rights Reserved.

bottom of page