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 .
Short-term combined effects of thoracic spine thrust manipulation and cervical spine nonthrust manipulation in individuals with mechanical neck pain: a randomized clinical trial.
STUDY DESIGN R and omized clinical trial . OBJECTIVE To investigate the short-term effects of thoracic spine thrust manipulation combined with cervical spine nonthrust manipulation ( experimental group ) versus cervical spine nonthrust manipulation alone ( comparison group ) in individuals with mechanical neck pain . BACKGROUND Research has demonstrated improved outcomes with both nonthrust manipulation directed at the cervical spine and thrust manipulation directed at the thoracic spine in patients with neck pain . Previous studies have not determined if thoracic spine thrust manipulation may increase benefits beyond those provided by cervical nonthrust manipulation alone . METHODS Sixty-four participants with mechanical neck pain were r and omized into 1 of 2 groups , an experimental or comparison group . Both groups received 2 treatment sessions of cervical spine nonthrust manipulation and a home exercise program consisting of active range-of-motion exercises , and the experimental group received additional thoracic spine thrust manipulations . Outcome measures were collected at baseline and at a 1-week follow-up , and included the numeric pain rating scale , the Neck Disability Index , and the global rating of change . RESULTS Participants in the experimental group demonstrated significantly greater improvements ( P<.001 ) on both the numeric pain rating scale and Neck Disability Index at the 1-week follow-up compared to those in the comparison group . In addition , 31 of 33 ( 94 % ) participants in the experimental group , compared to 11 of 31 participants ( 35 % ) in the comparison group , indicated a global rating of change score of + 4 or higher at the 1-week follow-up , with an associated number needed to treat of 2 . CONCLUSION Individuals with neck pain who received a combination of thoracic spine thrust manipulation and cervical spine nonthrust manipulation plus exercise demonstrated better overall short-term outcomes on the numeric pain rating scale , the Neck Disability Index , and the global rating of change
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 .