The relative effectiveness of the combination of spinal manipulation and Homoeopathic Simillimum in the treatment of chronic mechanical neck pain
Background: According to Picavet and Schouten (2003) the incidence of neck pain is increasing at a greater rate than other spine problems (Hoving et al. 2004). Furthermore, chronic neck pain is a substantial burden to society with chronic neck pain being the fourth leading cause of disability worldwide (Hoy et al. 2014). Chronic mechanical neck pain (CMNP) has been defined as localised, asymmetrical neck pain with restricted range of motion and dysfunctional musculature (Grieve, 1988). Treatments for those suffering with chronic pain, which are non-surgical, appear to be the most beneficial for patients according to Haldeman et al. (2008). Giles and Müller (1999) have stated that spinal manipulation is the most effective method of treating spinal pain on its own. However, the literature suggests that there is benefit in combining manipulation with an “anti-inflammatory type” drug (Crawford 1988; Oberbaum 1998; Serrentino 2003). Many studies have been successfully conducted on Homoeopathic complexes to treat neck pain (Fisher 1986; Bohmer and Ambrus 1992; Hepburn 2000; Soeken 2004) however no study has yet to been carried out on the combination of Homoeopathic Simillimum (single remedy) and spinal manipulation for CMNP. Objective: The aim of this study was to determine if spinal manipulation and Homoeopathic Simillimum in combination are more relatively effective than spinal manipulation alone in the treatment of chronic mechanical neck pain. Methodology: This study was a randomised, blinded placebo controlled quantitative trial with a comparative clinical trial design. Thirty consenting participants with CMNP who met the inclusion criteria were randomly distributed between two treatment groups. Group A received spinal manipulation as well as Homoeopathic Simillimum and group B received spinal manipulation with placebo medication. Each participant received three treatments over a period of a week; with subjective and objective readings taken at every consultation. The subjective tools included the Numerical Pain Rating Scale and Canadian Memorial College of Chiropractic Neck Disability Index. Objective tools included the Algometer and CROM-II Goniometer. All data captured was analysed using SPSS version 24.0. Inferential and non-parametric analysis of the data were also be performed. Results: The results showed that no statistically significant differences were observed between the two groups in terms of subjective and objective measurements. However, there were statistically significant improvements seen in both groups equally in terms of ANOVA subjective and objective measurements i.e. both groups showed improvement. Conclusion: The results of this study concluded that no statistical or clinically significant changes were noticed between the groups and therefore the Homoeopathic Simillimum added no statistical significant improvements in those who received it over those participants who received placebo in the treatment of chronic mechanical neck pain.