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 .
Upper trapezius relaxation induced by TENS and interferential current in computer users with chronic nonspecific neck discomfort: An electromyographic analysis.
BACKGROUND Recent studies have shown that a transcutaneous electrical nerve stimulation ( TENS ) and interferential current ( IFC ) application reduces pain in subjects with musculoskeletal disorders . However there are no clinical trials evaluating or comparing the muscle relaxation generated for these devices . PURPOSE To compare the muscle relaxation of the upper trapezius induced by the application of TENS and IFC in females with chronic nonspecific neck discomfort . METHODS Sixty-four females between 18 and 40 years of age and a history of nonspecific neck discomfort were r and omly assigned to a TENS or an IFC group . The women in the TENS ( N = 32 ; mean age 22 years ) and IFC ( N = 32 , mean age 23 years ) group were su bmi tted to current application during 3 consecutive days and were assessed by  electromyography ( EMG ) in different times aim ing to quantify the muscular tension of the upper trapezius . A visual analogue scale ( VAS ) was used as pain measure at baseline ( before TENS or IFC application ) and at the end of the study . RESULTS At baseline , demographic , pain , and EMG assessment data were similar between groups . Those in the IFC group had a significant trapezius relaxation after 3 IFC applications when compared to baseline and intermediate evaluations ( P < 0.05 ) . In contrast , the same analysis showed no significant difference between all assessment s in the TENS group ( P > 0.05 ) . In relation to pain relief , both groups showed an improvement at the end of the study when compared to baseline ( both , P < 0.05 ) . The between-group analysis showed no difference for the subjects who received such IFC as TENS application ( P < 0.05 ) . CONCLUSION IFC induced the upper trapezius relaxation after 3 sessions in females with neck discomfort , but the TENS application did not change the muscular tension . However , these results should be carefully interpreted due to the lack of differences between groups . A significant pain decrease was found in the subjects of both groups , however , only the IFC application presented a clinical ly important improvement
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 .