"Modifications in patients with subacute or chronic mechanical neck pain after osteopathic treatment and conventional physiotherapeutic treatment"

Treatment Trial, randomized-controlled, parallel, double-blind, two-arm trial The capacity to carry out the study must be measured in the present availability of the means (material and human) necessary to carry it out: Material resources: - Hydraulic stretcher without drop - One caliber to measure the amplitude of the opening of the mouth, scientifically validated. - One Algometer to measure the pressure pain threshold (PDP), scientifically validated. - One goniometer to measure the range of cervical mobility, Cervical Range of Motion35 (CROM) validated scientifically. - Wide and comfortable room with constant temperature. - For the performance of quality clinical trials, precise tools are required to measure the results that are properly validated. For this, the cervical pain measurement scale and / or associated disability is used: Neck Disability Index (NDI). Human resources: - One therapist who performs osteopathic manipulative treatment and / or conventional physiotherapy with more than five years of experience. - One external evaluator to assess the parameters (Amplitude of the opening of the mouth, pain threshold to pressure" (PTP) and cervical mobility) assessing the interobserver and intraobserver reliability (2 measurements each observer). Perfectly trained and more than 5 years of experience. - Patients that meet the inclusion criteria determined, in an amount necessary for compliance with the study. STUDY PROTOCOL: 1- Random assignment of control and experimental groups (Arm-1 and Arm-2) (neither the patient nor the evaluators know the group in which the patient is located, thus achieving double blindness of the study). The mode of delivery will be face to face it will be provided individually before the interventions. a- Experimental group: (Arm-1) - Determine the patient's compliance with the inclusion criteria and that does not meet the exclusion criteria. - Reading of informative sheet. - Reading and signing of informed consent. - Reading and filling out the "Neck Disability Index" (NDI) questionnaire. Measurement scale of cervical pain and / or associated disability, to be able to see the difference of score between the experimental group and the control group in said numerical scale. - Control of ambient temperature (17-25 ºC). - The patient lies on the stretcher 10 minutes with both arms at chest level. - Measurement of the active vertical opening of the mouth before the intervention .. - Measurement of the "pain threshold to pressure" (PTP) of the triggerspoints that the patient presents in both masseters before the intervention. - Measurement of the goniometry of the cervical spine: - Realization of the osteopathic treatment: OSTEOPATHIC TREATMENT: 1. Global manipulation technique Occipito-alto-axoidea (OAA) according to Fryette Bilateral: 2. DOG TECHNIQUE IN BILATERAL EXTENSION for manipulation of dorsal vertebrae: 3. PELVIS GLOBAL TECHNIQUE: 4. Suboccipital Inhibition Technique 5. Thrust technique on the occipito-mastoid suture 6. Technique Mobilization in Cervical Extension (MEC) 7. Technique for the Mediastinum Previous 8. Inhibition of the Phrenic Center Technique - New measurement of active vertical opening of the mouth after the intervention after passing 1min. - New measurement of "pain threshold to pressure" (PTP) in trigger points of masseters after the intervention. - New measurement of the goniometry of the cervical spine 7 - Do it during 2 sessions, one session per week (every 7 days). 2 session of an hour approximately, once per week during two weeks. - The invertention will be performs in a private Physiotherapy Clinic. - At the end of the 2nd session, fill out Neck Disability Index (NDI) again and show if there were changes. b- Control group: (Arm-2) - Determine the patient's compliance with the inclusion criteria and that does not meet the exclusion criteria. - Reading of informative sheet. - Reading and signing of informed consent. - Reading and filling out the "Neck Disability Index" (NDI) questionnaire. Measurement scale of cervical pain and / or associated disability, to be able to see the difference of score between the experimental group and the control group in said numerical scale. - Control of ambient temperature (17-25 ºC). - The patient lies on the table for 5 minutes with both arms at chest level. - Measurement of the active vertical opening of the mouth before the intervention. - Measurement of "pain threshold to pressure" (PTP) in trigger points of masseters before the intervention. - Measurement of cervical goniometry - Performing the conventional physiotherapy treatment: - New measurement of active vertical opening of the mouth after the intervention after passing 1min. - New measurement of "pain threshold to pressure" (PTP) in trigger points of masseters after the intervention. - New measurement of cervical goniometry. - Do it during 2 sessions, one session per week (every 7 days). 2 session of half an hour approximately, once per week during two weeks. - The invertention will be performs in a private Physiotherapy Clinic. - At the end of the 2nd session, fill out Neck Disability Index (NDI) again and show if there were changes. 2- Data registration and statistical analysis