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 Usual Chiropractic Care for Spinal Pain: A Randomized Controlled Trial
Study Design . Parallel-group r and omized controlled trial . Objective . Establish the short-term effectiveness of chiropractic therapy for spinal pain compared with a sham intervention and explore the predictors of chiropractic treatment satisfaction . Summary of Background Data . Chiropractic treatment is widely used for spinal pain . However , a lack of sound evidence precludes conclusions about the effectiveness of chiropractic for spinal pain . Methods . Participants were adults experiencing spinal pain , r and omized to receive 2 treatments of chiropractic or sham therapy .  Participants and outcome assessors were blinded to group allocation . Primary outcomes at 2 weeks were pain intensity ( 0–10 scale ) and function ( 0–40 Functional Rating Index ) . Secondary outcomes were global change , minimum acceptable outcome , and treatment satisfaction . Treatment effects were estimated with linear mixed models for the primary outcomes . We used logistic regression to identify differences in the secondary outcomes and explore for predictors of treatment satisfaction . Results . One hundred eighty three participants ( chiropractic , n = 92 ; sham , n = 91 ) were recruited and included in the analyses . Participants receiving chiropractic therapy reported greater improvements in pain ( mean difference , 95 % confidence interval [ CI ] = 0.5 [ 0.1–0.9 ] ) , physical function ( mean difference [ 95 % CI ] = 2.1 [ 0.3–4.0 ] ) , and were more likely to experience global improvement ( 48 % vs. 24 % , P = 0.01 ) and treatment satisfaction ( 78 % vs. 56 % , P < 0.01 ) . There was no between-group difference in achieving a minimally acceptable outcome ( 34 % sham vs. 29 % chiropractic , P = 0.42 ) . Awareness of treatment assignment and achieving minimally important improvement in pain intensity were associated with chiropractic treatment satisfaction . Conclusion . Short-term chiropractic treatment was superior to sham ; however , treatment effects were not clinical ly important . Awareness of treatment assignment and clinical ly important reductions in pain were associated with chiropractic treatment satisfaction . Level of Evidence :
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 .