The Effectiveness of Mulligan's Techniques in Non-Specific Neck Pain: A Systematic Review and Meta-Analysis.
Jordana Barbosa-Silva, Alexandre Luc, Ana Izabela Sobral de Oliveira-Souza and 5 others
PMID 40439260WHAT IT FOUND
Mulligan's techniques alone did not outperform other manual therapies or exercises for neck pain.
When bundled with other treatments, some comparisons favored the combined group, but the evidence behind every result was weak and the role of any single component cannot be separated.
Key findings
01In acute and chronic non-specific neck pain, Mulligan's techniques applied alone did not show superiority over other manual therapies or exercise programs for pain, range of motion, or disability.
02When Mulligan's techniques were combined with conventional therapy, exercises, or myofascial release, some comparisons favored the combined group over the other treatments alone, but the paper states the effectiveness was associated with several interventions given together and that the limited impact of Mulligan mobilization alone was highlighted.
03Twenty-nine of the 33 included studies were rated high risk of bias, none were rated low, and every comparison was classified as very low certainty.
STILL TO COME
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What it does not show
Twenty-nine of the 33 included studies were rated high risk of bias and none were rated low, so the underlying trials had problems with randomisation, blinding, and allocation concealment. Every comparison was rated very low certainty by GRADE, meaning the results are fragile and could change with new data. Several meta-analyses showed high heterogeneity (I² of 80% to 97%), and the authors flagged these results for interpretation with caution. Two studies did not report numerical results, and several authors did not respond to requests for clarification, limiting the ability to assess clinical significance. Eight studies did not specify whether their participants had acute, subacute, or chronic neck pain. The interventions and comparators varied widely across studies, making it difficult to isolate the effect of any single technique. Compliance and adherence to treatment were poorly reported by the included trials, so it is unclear whether participants actually received the full course of therapy.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not read the combined-treatment results as evidence that Mulligan's techniques specifically work. The paper states the effectiveness was associated with several interventions given together, and the contribution of any single component cannot be separated. Every comparison was rated very low certainty, and 29 of 33 included trials had high risk of bias.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →