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 .
Yoga for chronic neck pain: a pilot randomized controlled clinical trial.
UNLABELLED Yoga has been found effective in the treatment of  chronic low back pain . We aim ed to evaluate the effectiveness of Iyengar yoga in chronic neck pain by means of a r and omized clinical trial . Seventy-seven patients ( aged 47.9 ± 7.9 , 67 female ) with chronic neck pain who scored > 40 mm on a 100-mm visual analog scale ( VAS ) were r and omized to a 9-week Iyengar yoga program  with weekly 90-minute classes ( n = 38 ) or to a self-care/exercise program ( n = 38 ) . Patients were examined at baseline and after 4 and 10 weeks . The primary outcome measure was change of mean pain at rest ( VAS ) from baseline to week 10 . Secondary outcomes included pain at motion , functional disability , quality of life ( QOL ) , and psychological outcomes . Twelve patients in the yoga group and 11 patients in the self-care/exercise group were lost to follow-up , with higher study nonadherence in the self-care group ( 5 versus 10 patients ) . Mean pain at rest was reduced from 44.3 ± 20.1 to 13.0 ± 11.6 at week 10 by yoga and from 41.9 ± 21.9 to 34.4 ± 21.1 by self-care/exercise ( group difference : -20.1 , 95 % confidence interval : -30.0 , -10.1 ; P < .001 ) . Pain at motion was reduced from 53.4 ± 18.5 to 22.4 ± 18.7 at week 10 by yoga and from 49.4 ± 22.8 to 39.9 ± 21.5 by self-care/exercise ( group difference : -18.7 , 95 % confidence interval : -29.3 , -8.1 ; P < .001 ) . Significant treatment effects of yoga were also found for pain-related apprehension , disability , QOL , and psychological outcomes . Sensitivity analyses suggested minimal influence of dropout rates . Both programs were well tolerated . In this preliminary trial , yoga appears to be an effective treatment in chronic neck pain with possible additional effects on psychological well-being and QOL . The effectiveness of yoga in chronic neck pain should be further tested by comparative effectiveness studies with longer observation periods . PERSPECTIVE This article presents the results of a r and omized controlled trial on the clinical effects of a 9-week yoga program or self-care exercise in patients with chronic neck pain . Yoga led to superior pain relief and functional improvements and might be a useful treatment option for chronic neck pain
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 .