Neck Mobilisation and Manipulation

By Lieve Lievens, Physiotherapist

 What is manipulation and why use it?

There are a variety of proven therapies and techniques used by Musculoskeletal Physiotherapists to treat conditions of the muscles, joints and nerves. Musculoskeletal Physiotherapists have undertaken relevant postgraduate study and/or have extensive experience in the field of musculoskeletal physiotherapy, so that they have advanced knowledge of particular conditions or areas of the body. Mobilisation and manipulation are two highly effective treatment approaches, particularly in the relief and prevention of back and neck pain. Mobilisation may be described as pressure by the hand to slowly coax movement of individual joints, while manipulation is defined as a controlled quick movement of a joint which often produces a clicking or popping sound.

Examination prior to manipulation


Although extremely rare, it is possible that manipulative treatment of the neck could contribute to a block in supply of blood to the brain or injury to the vertebral artery or nerves (see Potential complications below). 

To optimise your safety, your Musculoskeletal Physiotherapist will carry out an assessment prior to performing manipulation, to check for potential disturbance to the function of the spinal cord, nerves and the vertebral arteries.

The assessment will include a thorough history, assess your posture, examine your movements and conduct specific muscle and nerve tests to diagnose your problem, a physical examination of your neck, questioning, and may also inclu

de tests to discount any underlying problem with the blood flow in your vertebral arteries. If the Musculoskeletal Physiotherapist has any indication of abnormal function, they will modify the examination and treatment of your neck to avoid placing stress on the arteries, thus maximising the safety of your treatment. These tests do not give an absolute indication of risk but they do provide the best available assurance that it is safe for your Musculoskeletal Physiotherapist to precede with manipulation. Musculoskeletal Physiotherapists recognise that at all times you have the right to decline a proposed treatment.

 What can I expect after treatment?

 After treatment by a Musculoskeletal Physiotherapist you should have less pain, be more flexible and mobile, and feel more comfortable in your movements. You will also have a better understanding of what is causing your problem and how to pre

vent it recurring. Some patients will experience mild post-treatment soreness in the first twenty-four hours after treatment. Relief should be significant and long-lasting. Depending on your individual circumstances, this may occur after a single visit, or it may take several visits.

 Potential Complications

The cervical spine (or neck) is composed of seven individual vertebrae, connected by ligaments and muscles. This forms part of the spinal column, in which runs the spinal cord and some important arteries, both of which pass through the cervical spine to the brain. Neck manipulation is a treatment commonly performed safely by Musculoskeletal Physiotherapists and by other health practitioners with specialised training in manipulative techniques. Research evidence indicates that neck manipulation is safer than taking anti-inflammatory medication (NSAIDs). However, in rare circumstances, complications from neck manipulation can occur. These may involve injury to, or blockage

 of, the vertebral arteries, with the potential to cause a stroke or even death. There is also a very small risk of damage to nerves, bones, muscles, ligaments or arteries, or that the manipulation may produce pressure on nerves going down the arm.

 Your safety

 Musculoskeletal Physiotherapists are trained to know when and where to use manipulation and apply those techniques safely and effectively. If there 

is any indication you are at risk your physiotherapist will advise you and use alternative techniques. Your safety and comfort are paramount at all times.

 Is a referral needed?

Private clients: no referral needed. For Medicare, Veteran’s Affairs, Third Party and Work cover clients a referral is needed. Consultations can be claimed through private health insurance.

For further information or if you would like to make an appointment with a Physiotherapist for assessment ask at reception or call 4975-1622.