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 .
Five-Week Outcomes From a Dosing Trial of Therapeutic Massage for Chronic Neck Pain
PURPOSE This trial was design ed to evaluate the optimal dose of massage for individuals with chronic neck pain . METHODS We recruited 228 individuals with chronic nonspecific neck pain from an integrated health care system and the general population , and r and omized them to 5 groups receiving various doses of massage ( a 4-week course consisting of 30-minute visits 2 or 3 times weekly or 60-minute visits 1 , 2 , or 3 times weekly ) or to a single control group ( a 4-week period on a wait list ) . We assessed neck-related dysfunction with the Neck Disability Index ( range , 0–50 points ) and pain intensity with a numerical rating scale ( range , 0–10 points ) at baseline and 5 weeks . We used log-linear regression to assess the likelihood of clinical ly meaningful improvement in neck-related dysfunction ( ≥5 points on Neck Disability Index ) or pain intensity ( ≥30 % improvement ) by treatment group . RESULTS After adjustment for baseline age , outcome measures , and imbalanced covariates , 30-minute treatments were not significantly better than the wait list control condition in terms of achieving a clinical ly meaningful improvement in neck dysfunction or pain , regardless of the frequency of treatments . In contrast , 60-minute treatments 2 and 3 times weekly significantly increased the likelihood of such improvement compared with the control condition in terms of both neck dysfunction ( relative risk = 3.41 and 4.98 , P = .04 and .005 , respectively ) and pain intensity ( relative risk = 2.30 and 2.73 ; P = .007 and .001 , respectively ) . CONCLUSIONS After 4 weeks of treatment , we found multiple 60-minute massages per week more effective than fewer or shorter sessions for individuals with chronic neck pain . Clinicians recommending massage and research ers study ing this therapy should ensure that patients receive a likely effective dose of 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 .