Chiropractic Care for Neck Pain: Comparing Diversified Technique and Drop Table Method

The Drop Table Technique is a chiropractic intervention that utilizes a segmented treatment table with adjustable sections that can be elevated slightly and then dropped. During the procedure, a high-velocity, low-amplitude (HVLA) thrust is applied while the specific segment of the table drops slightly in coordination with the thrust. This technique aims to reduce the resistance experienced during the adjustment and to enhance the mechanical effect on targeted spinal joints. In this study, the Drop Table Technique will be specifically applied to the cervical spine to address mechanical neck pain. All applications will be performed by a licensed chiropractor using standardized positioning and adjustment protocols to ensure consistency across sessions.

Cervical spinal manipulation (SM) will be applied with the participant supine to restrictions found on motion palpation, following the technique described by Bergmann and Peterson. The participant's head and neck will be simultaneously rotated and laterally flexed over the contact point-specifically, the posterior supramastoid groove or zygomatic arch (C0-C1), the posterior aspect of the transverse process (C1-C2), or the posterior articular pillar of superior vertebrae (C2-C7)-to the end of passive range of motion (ROM). Subsequently, a high-velocity, low-amplitude thrust will be delivered in the direction of restricted movement. Participants with greater ROM restriction in the lateral plane will receive more laterally-to-medially directed thrusts. Participants with more restriction in rotation will be given thrusts in the direction of restricted axial rotation, and those with more restriction in extension will receive more anteriorly directed thrusts.