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 .
Examination of a Clinical Prediction Rule to Identify Patients With Neck Pain Likely to Benefit From Thoracic Spine Thrust Manipulation and a General Cervical Range of Motion Exercise: Multi-Center Randomized Clinical Trial
Background A clinical prediction rule ( CPR ) purported to identify patients with neck pain who are likely to respond to thoracic spine thrust manipulation has recently been developed , but has yet to be vali date d. Objective The purpose of this study was to examine the validity of this CPR . Design This was a multi-center r and omized clinical trial . Methods One hundred forty patients with a primary report of neck pain were r and omly assigned to receive either 5 sessions of stretching and strengthening exercise ( exercise-only group ) or 2 sessions of thoracic spine manipulation and cervical range of motion exercise followed by 3 sessions of stretching and strengthening exercise ( manipulation + exercise group ) . Data on disability and pain were collected at baseline , 1 week , 4 weeks , and 6 months . The primary aim ( treatment group × time × status on the prediction rule ) was examined using a linear mixed model with repeated measures . Time , treatment group , and status on the rule , as well as all possible 2-way and 3-way interactions , were modeled as fixed effects , with disability ( and pain ) as the dependent variable . Effect sizes were calculated for both pain and disability at each follow-up period . Results There was no 3-way interaction for either disability or pain . A 2-way ( group × time ) interaction existed for both disability and pain . Pair-wise comparisons of disability demonstrated that significant differences existed at each follow-up period between the manipulation + exercise group and the exercise-only group . The patients who received manipulation exhibited lower pain scores at the 1-week follow-up period . The effect sizes were moderate for disability at each follow-up period and were moderate for pain at the 1-week follow-up . Limitations Different exercise approaches may have result ed in a different outcome . Conclusions The results of the current study did not support the validity of the previously developed CPR . However , the results demonstrated that patients with mechanical neck pain who received thoracic spine manipulation and exercise exhibited significantly greater improvements in disability at both the short- and long-term follow-up periods and in pain at the 1-week follow-up compared with patients who received exercise only
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 .