Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: economic evaluation alongside a randomised controlled trialCommentary: Bootstrapping simplifies appreciation of statistical inferences

I do agree with the comments from Bruce M Gray & Saravana
Kumar that the design of the study of Ingeborg B C Korthals-de
Bos etal. poses many unanswered questions. However a very
simple thing that I can observe from the study is that both so
called "manual therapy" and "physiotherapy" are effective in
managing the neck pain patients.

In Hong Kong context, a neck pain patient will be examined by a
physiotherapist for a differentiate diagnosis for neck pain. The
possible causes of neck pain may include ligamentous sprain,
neck muscle strain, facet joint alignment problem, muscle
imbalance, postural problem, or overuse syndrome, etc. will be
identified clinically. And the treatment plan will be discussed
with the patient. With patient consensus, physiotherapy
treatments which may include back exercises, spinal mobilization,
spinal manipulation, postural correction exercises, muscle
balancing exercise, electrotherapy for sprain or strain, and
sometime, Yoga, pilate or progressive stretching exercises may be
included for later stage of neck pain rehabilitaition.

Our experience and practice are consistant to the comment of
Deanne M Quartermaine that manual therapy is one of the
components of the physiotherapy services in Hong Kong.

May I used this opportunity to thank Ingeborg B C Korthals-de Bos
and co-workers in reporting their study in supporting
physiotherapy for their neck patients. Further research for neck
pain and physiotherapy is beneficial to the public with active
participation of multi-disciplinary medical professions in future.

Competing interests:  
None declared