The Minster Practice, Lichfield

Many treatment options are available for neck pain, but there is little agreement on the preferred method. Thus, Dutch investigators performed this comprehensive evaluation. Forty-two general practitioners recruited 182 patients who had experienced neck pain for at least 2 weeks. The participants were assigned randomly to 1 of 3 treatment groups: manual therapy, which consisted of spinal mobilization (i.e., low-velocity passive movements within the limit of joint range of motion; a technique used by chiropractors, osteopaths, and physiotherapists) provided by trained therapists; physiotherapy, which was mainly exercise; or general practitioner care, which included counselling, education, and drugs. Patients were followed for 1 year.

At 7 weeks, recovery rates were 68% for manual therapy, 51% for physiotherapy, and 36% for GP care. At 26 weeks, the differences were less dramatic but were still significant; by 52 weeks, the differences were no longer significant. Work absenteeism caused by neck pain was noted for 9 manual-therapy patients, for 12 physiotherapy patients, and for 15 GP-care patients. The total cost of care for manual therapy -- about US$400 yearly per patient -- was about one third the cost of physiotherapy or GP care.

Comment— Keith I. Marton, MD  Published in Journal Watch May 30, 2003
Although systematic reviews have shown little evidence that any particular treatment is better than another for neck pain, this study showed that manual therapy led to faster recovery and slightly better outcomes at 1 year, with costs that were substantially lower than those of physiotherapy or usual care. Manual therapy might be the preferred approach to neck pain, but the relative effectiveness and costs of these treatments might look different in other settings. At the time of publication, the full text of the original article was available at http://bmj.com/cgi/content/full/326/7395/911 free of charge.
Source Korthals-de Bos IBC et al. Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: Economic evaluation alongside a randomised controlled trial. BMJ 2003 Apr 26; 326:911-4.

Queen Victoria's secret cure for arthritis

Source: Daily Mail Date: 01/06/2004
Aberdeen Royal Infirmary has conducted a trial on the medicinal benefits of Deeside mineral water and found that it offered "significant benefit" for 72 per cent of rheumatoid arthritis sufferers. The three-month study found that inflammation caused by arthritis fell by a fifth among those who drank the water every day. Experts suspect the water's low alkaline and mineral content may lie behind its ability to calm inflammation. The water is available from Asda, Sainsbury's and some Safeway and Waitrose stores and is also part of Prince Charles's Duchy Originals range.

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