Roland Bryans1, Philip Decina2, Martin Descarreaux3, Mireille Duranleau4, Henri Marcoux5, Brock Potter6, Richard P Ruegg7, Lynn Shaw8, Robert Watkin9, Eleanor White10. 1. Guidelines Development Committee (GDC) Chairman; Chiropractor, Clarenville, Newfoundland, Canada. 2. Assistant Professor, Canadian Memorial Chiropractic College, Clinical Education, Toronto, Canada. 3. Professor, Département de Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada. 4. Chiropractor, Montréal, Quebec, Canada. 5. Chiropractor, Winnipeg, Manitoba, Canada. 6. Chiropractor, North Vancouver, British Columbia, Canada. 7. Editor, Clinical Practice Guidelines Initiative, Toronto, Ontario, Canada. Electronic address: rruegg@cogeco.ca. 8. Associate Professor, Faculty of Health Sciences, School of Occupational Therapy, Western University, London, Ontario, Canada. 9. Public Member, Toronto, Ontario, Canada. 10. Chiropractor, Markham, Ontario, Canada.
Abstract
OBJECTIVE: The purpose of this study was to develop evidence-based treatment recommendations for the treatment of nonspecific (mechanical) neck pain in adults. METHODS: Systematic literature searches of controlled clinical trials published through December 2011 relevant to chiropractic practice were conducted using the databases MEDLINE, EMBASE, EMCARE, Index to Chiropractic Literature, and the Cochrane Library. The number, quality, and consistency of findings were considered to assign an overall strength of evidence (strong, moderate, weak, or conflicting) and to formulate treatment recommendations. RESULTS: Forty-one randomized controlled trials meeting the inclusion criteria and scoring a low risk of bias were used to develop 11 treatment recommendations. Strong recommendations were made for the treatment of chronic neck pain with manipulation, manual therapy, and exercise in combination with other modalities. Strong recommendations were also made for the treatment of chronic neck pain with stretching, strengthening, and endurance exercises alone. Moderate recommendations were made for the treatment of acute neck pain with manipulation and mobilization in combination with other modalities. Moderate recommendations were made for the treatment of chronic neck pain with mobilization as well as massage in combination with other therapies. A weak recommendation was made for the treatment of acute neck pain with exercise alone and the treatment of chronic neck pain with manipulation alone. Thoracic manipulation and trigger point therapy could not be recommended for the treatment of acute neck pain. Transcutaneous nerve stimulation, thoracic manipulation, laser, and traction could not be recommended for the treatment of chronic neck pain. CONCLUSIONS: Interventions commonly used in chiropractic care improve outcomes for the treatment of acute and chronic neck pain. Increased benefit has been shown in several instances where a multimodal approach to neck pain has been used.
OBJECTIVE: The purpose of this study was to develop evidence-based treatment recommendations for the treatment of nonspecific (mechanical) neck pain in adults. METHODS: Systematic literature searches of controlled clinical trials published through December 2011 relevant to chiropractic practice were conducted using the databases MEDLINE, EMBASE, EMCARE, Index to Chiropractic Literature, and the Cochrane Library. The number, quality, and consistency of findings were considered to assign an overall strength of evidence (strong, moderate, weak, or conflicting) and to formulate treatment recommendations. RESULTS: Forty-one randomized controlled trials meeting the inclusion criteria and scoring a low risk of bias were used to develop 11 treatment recommendations. Strong recommendations were made for the treatment of chronic neck pain with manipulation, manual therapy, and exercise in combination with other modalities. Strong recommendations were also made for the treatment of chronic neck pain with stretching, strengthening, and endurance exercises alone. Moderate recommendations were made for the treatment of acute neck pain with manipulation and mobilization in combination with other modalities. Moderate recommendations were made for the treatment of chronic neck pain with mobilization as well as massage in combination with other therapies. A weak recommendation was made for the treatment of acute neck pain with exercise alone and the treatment of chronic neck pain with manipulation alone. Thoracic manipulation and trigger point therapy could not be recommended for the treatment of acute neck pain. Transcutaneous nerve stimulation, thoracic manipulation, laser, and traction could not be recommended for the treatment of chronic neck pain. CONCLUSIONS: Interventions commonly used in chiropractic care improve outcomes for the treatment of acute and chronic neck pain. Increased benefit has been shown in several instances where a multimodal approach to neck pain has been used.
Authors: Ian D Coulter; Cindy Crawford; Howard Vernon; Eric L Hurwitz; Raheleh Khorsan; Marika Suttorp Booth; Patricia M Herman Journal: Pain Physician Date: 2019-03 Impact factor: 4.965
Authors: Greg Kawchuk; Genevieve Newton; John Srbely; Steven Passmore; André Bussières; Jason W Busse; Paul Bruno Journal: J Can Chiropr Assoc Date: 2014-09
Authors: Maruti Ram Gudavalli; Robert D Vining; Stacie A Salsbury; Lance G Corber; Cynthia R Long; Avinash G Patwardhan; Christine M Goertz Journal: Spine J Date: 2014-10-22 Impact factor: 4.166