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 .
The Effectiveness of Manual Physical Therapy and Exercise for Mechanical Neck Pain: A Randomized Clinical Trial
Study Design . R and omized clinical trial . Objective . To assess the effectiveness of manual physical therapy and exercise ( MTE ) for mechanical neck pain with or without unilateral upper extremity ( UE ) symptoms , as compared to a minimal intervention ( MIN ) approach . Summary of Background Data . Mounting evidence supports the use of manual therapy and exercise for mechanical neck pain , but no studies have directly assessed its effectiveness for UE symptoms . Methods . A total of 94 patients referred to 3 physical therapy clinics with a primary complaint of mechanical neck pain , with or without unilateral UE symptoms , were r and omized  to receive MTE or a MIN approach of advice , motion exercise , and subtherapeutic ultrasound . Primary outcomes were the neck disability index , cervical and UE pain visual analog scales ( VAS ) , and patient-perceived global rating of change assessed at 3- , 6- , and 52-weeks . Secondary measures included treatment success rates and post-treatment healthcare utilization . Results . The MTE group demonstrated significantly larger reductions in short- and long-term neck disability index scores ( mean 1-year difference −5.1 , 95 % confidence intervals ( CI ) −8.1 to −2.1 ; P = 0.001 ) and short-term cervical VAS scores ( mean 6-week difference −14.2 , 95 % CI −22.7 to −5.6 ; P = 0.001 ) as compared to the MIN group . The MTE group also demonstrated significant within group reductions in short- and long-term UE VAS scores at all time periods ( mean 1-year difference −16.3 , 95 % CI −23.1 to −9.5 ; P = 0.000 ) . At 1-year , patient perceived treatment success was reported by 62 % ( 29 of 47 ) of the MTE group and 32 % ( 15 of 47 ) of the MIN group ( P = 0.004 ) . Conclusion . An impairment-based MTE program result ed in clinical ly and statistically significant short- and long-term improvements in pain , disability , and patient-perceived recovery in patients with mechanical neck pain when compared to a program comprising advice , a mobility exercise , and subtherapeutic ultrasound
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 .