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 .
Strain-counterstrain to treat restrictions of the mobility of the cervical spine in patients with neck pain: a sham-controlled randomized trial.
OBJECTIVE Strain-counterstrain is an osteopathic technique which is widely used for treating mobility restrictions in the neck . We aim ed to investigate whether a single strain-counterstrain intervention is more effective than a sham intervention in improving restricted cervical range of motion in patients with neck pain . METHODS 61 adult patients with neck pain and restricted cervical mobility were r and omly allocated to receive either a single strain-counterstrain intervention or a sham treatment . After outcome measurement all patients received full individualized osteopathic treatment .  Mobility of the cervical spine was measured by a blinded observer using the Cervical Range of Motion ( CROM ) tool . In addition , patients rated pain intensity and assessed the treatment effect . The main outcome measure was the sum of changes in mobility restriction ( in % ) after treatment compared to normal mobility . RESULTS All patients completed the study . Mobility restriction decreased by 2.0 % ( SD 6.9 % ) in the group receiving strain-counterstrain treatment and 0.6 % ( SD 5.7 % ) in the group receiving sham treatment ( mean difference 1.5 % , 95 % confidence interval -1.7 to 4.8 % ; p=0.35 ) . There were no significant differences between groups for secondary outcomes . After receiving the full osteopathic treatment the group initially receiving strain-counterstrain improved by another 4.2 % ( 7.0 % ; p=0.003 ) and the group initially receiving sham by another 5.6 % ( SD 6.8 % ; p<0.001 ) . CONCLUSIONS Strain-counterstrain as a single intervention did not have immediate effects on mobility and pain over a sham treatment . Future studies should probably focus on the investigation of full osteopathic treatment
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 .