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 .
Intramuscular ketorolac versus osteopathic manipulative treatment in the management of acute neck pain in the emergency department: a randomized clinical trial.
Ketorolac tromethamine injected intramuscularly ( IM ) has been shown to be an effective analgesic in treating patients with acute musculoskeletal pain in the emergency department ( ED ) . The authors compare the efficacy of a single dose of IM ketorolac to osteopathic manipulative treatment ( OMT ) as delivered in the ED for the management of acute neck pain . A r and omized clinical trial was conducted in three EDs . A convenience sample of 58 patients with acute neck pain of less than three weeks ' duration were enrolled . Subjective measures of pain intensity on an 11-point numerical rating scale were gathered from patients immediately before treatment and one hour afterward . Subjects received either OMT or 30 mg , IM ketorolac . Subjects ' perceived pain relief was also recorded at one hour after treatment on a subjective 5-point pain relief scale . Twenty-nine patients received IM ketorolac , and 29 patients received OMT . Although both groups showed a significant reduction in pain intensity , 1.7+/-1.6 ( P < .001 [ 95 % CI , 1.1 - 2.3 ] ) and 2.8+/-1.7 ( P < .001 [ 95 % CI , 2.1 - 3.4 ] ) , respectively , patients receiving OMT reported a significantly greater decrease in pain intensity ( P=.02 [ 95 % CI , 0.2 - 1.9 ] ) . When comparing pain relief at one hour posttreatment , there was no significant difference between the OMT and ketorolac study groups ( P=.10 ) . The authors found that , at one hour posttreatment , OMT is as efficacious as IM ketorolac in providing pain relief and significantly better in reducing pain intensity . The authors conclude that OMT is a reasonable alternative to parenteral nonsteroidal anti-inflammatory medication for patients with acute neck pain in the ED setting
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 .