What was the study about?
The primary aim of the study was to investigate whether responders and non-responders to the initial treatment would benefit from a subsequent, individually tailored treatment plan. The researchers examined 126 individuals aged 18 and older, with an average age of 56, all experiencing persistent or recurring neck pain. All participants first took part in a two-week program involving stretching exercises, divided into two groups: one group performed only stretching exercises, while the other combined the exercises with manual therapy. Afterwards, all participants were offered an additional two months of treatment, which could be individually adjusted by their practitioner based on their specific needs.
What did the researchers find?
For those who did not improve with the initial treatment, individualized care led to better function and less disruption in daily life – even though the pain itself did not necessarily decrease.
For those who had already improved after the first phase, receiving more treatment actually made the pain worse during the individualized phase. This suggests that more treatment is not always better – and may even interfere with the body’s natural recovery process.
What does this mean for patients?
The study highlights that treatment should be based on each patient’s individual needs and response – not on a “one-size-fits-all” approach. If a patient has already improved from standard treatment (≥ 2 points improvement on an 11-point pain scale), further treatment may not offer additional benefit. Conversely, individualized treatment may make a meaningful difference for those who have not improved with standard care.
Professional recommendation
Healthcare professionals should carefully consider whether additional treatment is necessary – especially if the patient has already responded well. For patients who have not seen improvement, a more targeted and tailored approach may be the best path forward.
Anders Galaasen Bakken, Andreas Eklund, Anna Oksanen, Iben Axén. The response to individualized treatment after a standardized treatment protocol among neck pain sufferers: a secondary analysis of a randomized controlled trial. Chiropractic & Manual Therapies 2025.