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 .
Dry-needling and exercise for chronic whiplash-associated disorders: a randomized single-blind placebo-controlled trial
Abstract This r and omized controlled trial investigated the effectiveness and cost-effectiveness of dry-needling and exercise compared with sham dry-needling and exercise for chronic whiplash-associated disorders ( WAD ) . The setting was a single university centre and 4 physiotherapy practice s in Queensl and , Australia . Eighty patients with chronic WAD ( > 3 months ) were enrolled between June 2009 and August 2012 with 1-year follow-up completed in August 2013 . The interventions were 6 weeks of dry-needling to posterior neck muscles ( n = 40 ) and exercise or sham dry-needling and exercise ( n = 40 ) . The primary outcomes of the Neck Disability Index ( NDI ) and self-rated recovery were measured at baseline , 6 and 12 weeks , 6 and 12 months by a blinded assessor . Analysis was intention to treat . An economic evaluation was planned but missing data deemed further analysis unwarranted . Seventy-nine patients ( 99 % ) were followed up at 6 weeks , 78 ( 98 % ) at 12 weeks , 74 ( 93 % ) at 6 months , and 73 ( 91 % ) at 12 months . The dry-needling and exercise intervention was more effective than sham dry-needling and exercise  in reducing disability at 6 and 12 months but not at 6 and 12 weeks . The treatment effects were small and not clinical ly worthwhile . At 6 weeks , the treatment effect on the 0 - 100 NDI was −0.3 ( 95 % confidence interval −5.4 to 4.7 ) , 12 weeks −0.3 ( −5.2 to 4.9 ) , 6 months −4.4 ( −9.6 to −0.74 ) , and 12 months −3.8 ( −9.1 to −0.5 ) . There was no effect for self-rated recovery . In patients with chronic WAD  , dry-needling and exercise has no clinical ly worthwhile effects over sham dry-needling and exercise
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 .