Why neck pain deserves more than a quick fix

If you've ever woken up with a stiff, aching neck that lingers for days—or even weeks—you're not alone. Neck pain is one of the most common musculoskeletal problems worldwide, as more than 3,500 people out of every 100,000 have it at any given time. In addition, nearly half of all individuals who experience an acute episode of neck pain continue to deal with recurring discomfort months later.

Whether it starts from long hours at a desk, a sports injury, or simply “waking up wrong,” persistent neck pain can interfere with work, sleep, and daily activities. When this occurs, many of us will reach for over-the-counter pain relievers or even prescription medications for relief, but a growing body of research has been showing that a hands-on treatment approach with manual therapy is far more effective in the long term.

A closer look at pain medications and manual therapy

In many cases, patients with neck pain first try over–the–counter pain medications like acetaminophen and nonsteroidal anti–inflammatory drugs (NSAIDs) for immediate, short–term relief. Others may be prescribed something stronger like an opioid for severe pain or if over–the–counter medications fail to adequately alleviate their pain. While these medications can certainly reduce pain levels, they are only capable of doing so in the short term. In addition, pain medications can lead to potential side effects like stomach irritation, drowsiness, and, for opioids, a significant risk for abuse and addiction.

Another leading option for neck pain is manual therapy, which is a hands–on approach performed by physical therapists. Manual therapy includes gentle joint mobilization, targeted manipulations, and soft–tissue techniques to ease stiffness, improve movement, and calm irritated nerves. It is typically combined with exercises that are intended to strengthen supporting muscles and improve posture, which can lead to long–lasting benefits.

Study finds manual therapy to be safer and more effective than medications

Given the widespread use of both pain medications and manual therapy, researchers wanted to know which is truly safer and more effective for adults with neck pain. Therefore, they conducted a systematic review and meta–analysis to evaluate these two interventions in the management of neck pain. This type of study involved a comprehensive search for relevant articles comparing these two approaches head–to–head to determine which was safer and more effective at reducing pain. The search led to nine studies called randomized clinical trials being included for analysis, which studied 779 patients with neck pain.

Results found that manual therapy may be more effective than oral pain medications at reducing pain, both in the short term (within a few weeks of treatment) and the long term (up to a year later). This highlights the power of physical therapy to be more than just a temporary fix, as it may instead provide lasting relief from neck pain.

Manual therapy also appeared to be the safer of the two interventions, as the incidence of side effects was slightly lower for patients who received manual therapy than those who took an oral pain medication. The most common side effect with manual therapy was an increase in pain, which was temporary and moderate, while common side effects in those who took pain medications included stomach issues, drowsiness, and dry mouth. This finding suggests that the risk for side effects may be lower with manual therapy, but researchers urged caution when analyzing these results because different strategies were used for reporting side effects with these two interventions.

Finally, patients taking medications had a higher dropout rate than those receiving manual therapy, suggesting that manual therapy may also be a more tolerable intervention.

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These findings offer a powerful message: for those dealing with neck pain, manual therapy is a far better option than pain medications. Each patient who follows this treatment pathway will work directly with a physical therapist, who will address the root cause of their pain, improve their body's function, and help them find lasting relief. Physical therapy is a non–pharmacological approach that may provide significant pain relief and leave patients with fewer side effects in the process.

So, if persistent neck pain is holding you back, consider scheduling an evaluation with one of our licensed physical therapists. With a personalized plan that will likely include manual therapy and a comprehensive exercise program, you can move beyond short–term relief and toward lasting comfort and strength. While every case is unique and some people may still need to take medications, the evidence clearly shows that hands-on care can play a powerful role in your recovery.

For more information on manual therapy for neck pain, click here to read the full publication.