For workers with persistent neck and shoulder pain , evidence supports mixed supervised and unsupervised high-intensity strength training or advice alone ( grade s I-III NAD ) .
A multimodal approach including manual therapy , self-management advice , and exercise is an effective treatment strategy for both recent-onset and persistent neck pain
OBJECTIVE The objective was to develop a clinical practice guideline on the management of neck pain-associated disorders ( NADs ) and whiplash-associated disorders ( WADs ) .
This guideline replaces 2 prior chiropractic guidelines on NADs and WADs .
Multimodal treatment program comparing 2 different traction approaches for patients with discogenic cervical radiculopathy: a randomized controlled trial.
OBJECTIVE The purpose of this study was to investigate the immediate and long-term effects of a 1-year multimodal program with the addition of 2 different traction approaches on the pain , function , disability , and nerve root function in patients with discogenic cervical radiculopathy ( CR ) . This study also attempted to identify the optimal traction angle based on the maximum recovery of the peak-to-peak amplitude of the flexor carpi radialis ( FCR ) H-reflex . METHODS This r and omized clinical trial with one-year follow-up included a total of 216 ( 101 female ) patients with unilateral lower discogenic CR were r and omly assigned to 1 of 3 groups . The st and ard care group ( C ) received the multimodal program ( pain relief methods , muscle strengthening , and thoracic spine manipulation ) . The ventroflexion traction group ( A ) received the same multimodal program as group C , with added traditional ventroflexion traction . The novel traction group ( B ) received the same multimodal program as group C in addition to a flexor carpi radialis ( FCR ) H-reflex-based traction method . Primary outcomes were the Neck Disability Index ( NDI ) and secondary outcomes included neck pain , arm pain , and the amplitude and latency of the H-reflex . Patients were assessed at 3 intervals ( pre-treatment , 4 weeks post-treatment , and the 1-year follow-up ) . RESULTS The mixed linear model with repeated measures indicated a significant group × time effect in favor of the novel cervical traction group ( B ) for measures of NDI ( F = 412.6 , P < .0005 ) , neck pain ( F = 108.9 , P < .0005 ) , arm pain ( F = 91.3 , P < .0005 ) , H- reflex amplitude ( F = 207.7 , P < .0005 ) , and H-reflex latency ( F = 58.9 P < .0005 ) . We found that the extension position of cervical spine ( 5 ° extension ) was the position that achieved the maximum improvement in the novel cervical traction method . CONCLUSIONS This preliminary study showed that a multimodal program with a novel cervical traction method added improved NDI , neck pain , arm pain , and the amplitude and latency of FCR H-reflex for a group of patients with chronic discogenic CR
For workers with persistent neck and shoulder pain , evidence supports mixed supervised and unsupervised high-intensity strength training or advice alone ( grade s I-III NAD ) .
A multimodal approach including manual therapy , self-management advice , and exercise is an effective treatment strategy for both recent-onset and persistent neck pain
OBJECTIVE The objective was to develop a clinical practice guideline on the management of neck pain-associated disorders ( NADs ) and whiplash-associated disorders ( WADs ) .
This guideline replaces 2 prior chiropractic guidelines on NADs and WADs .