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 .
Cervical collar or physiotherapy versus wait and see policy for recent onset cervical radiculopathy: randomised trial
Objective To evaluate the effectiveness of treatment with collar or physiotherapy compared with a wait and see policy in recent onset cervical radiculopathy . Design R and omised controlled trial . Setting Neurology outpatient clinics in three Dutch hospitals . Participants 205 patients with symptoms and signs of cervical radiculopathy of less than one month ’s duration Interventions Treatment with a semi-hard collar and taking rest for three to six weeks ; 12 twice weekly sessions of physiotherapy and home exercises for six weeks ; or continuation of daily activities as much as possible without specific treatment ( control group ) . Main outcome measures Time course of changes in pain scores for arm and neck pain on a 100 mm visual analogue scale and in the neck disability index during the first six weeks . Results In the wait and see group , arm pain diminished by 3 mm/week on the visual analogue scale ( β=−3.1 mm , 95 % confidence interval −4.0 to −2.2 mm ) and by 19 mm in total over six weeks . Patients who were treated with cervical collar or physiotherapy achieved additional pain reduction ( collar : β=−1.9 mm , −3.3 to −0.5 mm ; physiotherapy : β=−1.9 , −3.3 to −0.8 ) , result ing in an extra pain reduction compared with the control group of 12 mm after six weeks . In the wait and see group , neck pain did not decrease significantly in the first six weeks ( β=−0.9 mm , −2.0 to 0.3 ) . Treatment with the collar result ed in a weekly reduction on the visual analogue scale of 2.8 mm ( −4.2 to −1.3 ) , amounting to 17 mm in six weeks , whereas physiotherapy gave a weekly reduction of 2.4 mm ( −3.9 to −0.8 ) result ing in a decrease of 14 mm after six weeks . Compared with a wait and see policy , the neck disability index showed a significant change with the use of the collar and rest ( β=−0.9 mm , −1.6 to −0.1 ) and a non-significant effect with physiotherapy and home exercises . Conclusion A semi-hard cervical collar and rest for three to six weeks or physiotherapy accompanied by home exercises for six weeks reduced neck and arm pain substantially compared with a wait and see policy in the early phase of cervical radiculopathy . Trial registration Clinical trials NCT00129714
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 .