562- New Evidence on Cervical Adjustments: Immediate Effects on Pain and Muscle Response

Cervical spine manipulation offers superior clinical and neuromechanical benefits compared to mobilization for patients with chronic neck pain. A 2026 randomized crossover trial involving 89 participants demonstrated that high-velocity, low-amplitude adjustments reduced pain twice as effectively as mobilization and produced greater improvements in cervical range of motion. Surface EMG data revealed significantly higher muscle activity during adjustments, specifically in the sternocleidomastoid and upper trapezius muscles. While both interventions are recognized in clinical practice guidelines, the mechanical and physiological impact of the adjustment—particularly its ability to reach the paraphysiological space—distinguishes it from the slower, oscillating nature of mobilization. These findings underscore the unique therapeutic value of chiropractic adjustments, reinforcing the importance of clinical skill and precise application in managing chronic neck pain to achieve optimal patient outcomes.