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Table 9

Summary of findings of massage for neck pain (only pain and functional outcomes).

Duration and cause of painOutcomesGRADE*Findings
Massage versus no treatment

Acute/subacute or mixed (specific, nonspecific)NA Insufficient
No trial
NA

Chronic specificDisability score (NPQ) Low
Design: RCT
ROB: Medium
Consistency: NA (only 1 trial)
Directness: yes
In one trial [148] massage was significantly better than “no treatment” immediately after treatment (mean NPQ score: 13.24 ± 11.88 versus 35.64 ± 12.54).

Chronic nonspecificNA Insufficient
No trial
NA

Unknown specificNo pain or disability outcome reportedNAOne trial [149] reporting PPT.

Unknown nonspecificPain intensity score (VAS) Low
Design: RCT
ROB: Medium
Consistency: NA (only 1 trial)
Directness: yes
In one trial [150] both classical and modified massage techniques (strain/counter-strain) were significantly better than “no treatment” immediately after treatment (P < 0.001). There was no significant difference between modified and classical massage (mean difference in VAS score: 0.5, 95% CI: −1.0, 1.1).
Classical versus “no treatment” (2.7, 95% CI: 1.6, 3.7).
Modified versus “no treatment” (2.6, 95% CI: 1.5, 3.7).

Massage versus placebo

Acute/subacute specificNA Insufficient
No trial
NA

Acute/subacute nonspecific≥2-point decrease on pain score (NRS-11) Low
Design: RCT
ROB: Medium
Consistency: NA (only 1 trial)
Directness: yes
In one trial [151] massage was significantly better than placebo immediately after treatment (OR: 7.4, 95% CI: 1.22, 45.02).

Chronic specificPain intensity score (VAS) Low
Design: RCT
ROB: High
Consistency: NA (only 1 trial)
Directness: yes
In one trial [209] massage was significantly better than placebo (sham laser) immediately or short-term after treatment (VAS: 7.89 versus 17.28, P < 0.05).

Chronic nonspecificNA Insufficient
No trial
NA

Mixed (specific, nonspecific)NA Insufficient
No trial
NA

Unknown specificNA Insufficient
No trial
NA

Unknown nonspecificNo pain or disability outcome reportedNAOne trial [152] reporting PPT.

Massage versus pain medication

Acute/subacute, chronic, mixed, or unknown (specific, nonspecific)NA Insufficient
No trial
NA

Massage versus mobilization (see Table 7 for mobilization for neck pain)

Massage versus manipulation (see Table 5 for manipulation for neck pain)

Massage versus usual care

Acute/subacute, chronic, mixed, or unknown (specific, nonspecific)NA Insufficient
No trial
NA

Massage versus physiotherapy

Acute/subacute, chronic, mixed, or unknown (specific, nonspecific)NA Insufficient
No trial
NA

Massage versus Exercise

Acute/subacute, mixed, or unknown (specific, nonspecific)NA Insufficient
No trial
NA

Chronic specificDisability score (NPQ) Low
Design: RCT
ROB: Medium
Consistency: NA (only 1 trial)
Directness: yes
In one trial [148] massage was significantly better than exercise immediately after treatment (mean NPQ score: 13.24 ± 11.88 versus 20.23 ± 12.06).

Chronic nonspecificNA Insufficient
No trial
NA

Massage versus acupuncture (see Table 3 for acupuncture for neck pain)

*Precision in formal grading was applied only to pooled results.

VAS: visual analog scale; RMDQ: Roland-Morris disability scale; NHP: Nottingham health profile; MPQ: McGill pain questionnaire; PDI: pain disability index; SF: short form; NPQ: neck pain questionnaire; SF-PQ: short form pain questionnaire; PRI: pain rating index; PPI: present pain intensity; NA: not applicable; NDI: neck disability index; IQR: interquartile. range; PPT: pressure pain threshold; OR: odds ratio; 95% CI: ninety-five percent confidence interval.

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