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 .
α-Lipoic Acid and Superoxide Dismutase in the Management of Chronic Neck Pain: A Prospective Randomized Study
Background and ObjectiveS ince oxidative stress plays a pathogenetic role in chronic neck pain ( CNP ) , we investigated whether a combination of α-lipoic acid ( ALA ) and superoxide dismutase ( SOD ) might improve pain control and the efficacy of physiotherapy ( “ multimodal therapy ” ) in patients with CNP . Setting This study was conducted in the Rehabilitation Unit of the Department of Surgical and Oncological Sciences at the University Policlinic in Palermo , Italy . Design and Patients This was a prospect i ve , r and omized , open study in out patients .Intervention Patients r and omly received either physiotherapy alone  ( group 2 ; n = 45 ) or a combination of ALA 600 mg and SOD 140 IU daily in addition to physiotherapy  ( group 1 ; n = 51 ) , for 60 days . Pain was assessed by a visual analogue scale ( VAS ) and a modified Neck Pain Question naire ( mNPQ ) . Treatment compliance and safety were also evaluated . Results Both groups experienced a significant reduction in the VAS and mNPQ scores after 1 month ; however , while no further improvement was observed in group 2 at 60 days , group 1 showed a further VAS reduction ( p < 0.001 ) . In addition , in the mNPQ at 60 days , more patients in group 1 than in group 2 reported that their neck pain was improved ( p < 0.01 ) , and they showed greater compliance with prescribed physiotherapy ( p = 0.048 ) . No drug reaction was observed . Conclusion Use of ALA/SOD in combination with physiotherapy may be a useful approach to CNP , being antioxidants that act on nerve inflammation and disease progression . Clinical Rehabilitation ImpactThese preliminary observations suggest that some interesting goals ( better pain control and physical wellbeing ) can be achieved by multimodal therapy in CNP patients
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 .