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 .
Time-Wise Change in Neck Pain in Response to Rehabilitation with Specific Resistance Training: Implications for Exercise Prescription
Purpose To determine the time-wise effect of specific resistance training on  neck pain among industrial technicians with frequent neck pain symptoms . Methods Secondary analysis of a parallel-group cluster r and omized controlled trial of 20 weeks performed at two large industrial production units in Copenhagen , Denmark . Women with neck pain > 30 mm VAS ( N = 131 ) were included in the present analysis . The training group ( N = 77 ) performed specific resistance training for the neck/shoulder muscles three times a week , and the control group ( N = 54 ) received advice to stay active . Participants of both groups registered neck pain intensity ( 0–100 mm VAS ) once a week . Results Neck pain intensity was 55 mm ( SD 23 ) at baseline . There was a significant group by time interaction for neck pain ( F-value 2.61 , P<0.001 , DF = 19 ) . Between-group differences in neck pain reached significance after 4 weeks ( 11 mm , 95 % CI 2 to 20 ) . The time-wise change in pain showed three phases ; a rapid decrease in the training group compared with the control group during the initial 7 weeks , a slower decrease in pain during the following weeks ( week 8–15 ) , and a plateau during the last weeks ( week 16–20 ) . Adherence to training followed a two-phase pattern , i.e. weekly participation rate was between 70–86 % during the initial 7 weeks , dropping towards 55–63 % during the latter half of the training period . Conclusion Four weeks of specific resistance training  reduced neck pain significantly , but 15 weeks is required to achieve maximal pain reduction . The time-wise change in pain followed a three-phase pattern with a rapid effect during the initial 7 weeks followed by a slower but still positive effect , and finally a plateau from week 15 and onwards . Decreased participation rate may explain the decreased efficacy during the latter phase of the intervention
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 .