Neck Pain Tool-kit: Step 4: Difference between revisions
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== Acute/subacute neck pain == | == Acute/subacute neck pain == | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to ''[[Neck Pain Tool-kit: Step 1|''Step 1: Identify your patient'']] | |||
=== Thoracic manipulation === | === Thoracic manipulation === | ||
==== Cleland 2005<ref name="Cleland 2005">Cleland JA, Childs Maj JD, McRae M, Palmer JA, Stowell T. Immediate effects of a thoracic manipulation in patients with neck pain: A randomized clinical trial. Manual Therapy 2005;10: 127–35.</ref> ==== | |||
==== Cleland | |||
{| width="700" border="1" cellpadding="1" cellspacing="1" | {| width="700" border="1" cellpadding="1" cellspacing="1" | ||
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== Subacute/chronic neck pain == | == Subacute/chronic neck pain == | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to ''[[Neck Pain Tool-kit: Step 1|''Step 1: Identify your patient'']] | |||
=== Manual therapy and exercise === | === Manual therapy and exercise === | ||
==== Bronfort 2001<ref name="Bronfort 2001">Bronfort G, Evan R, Nelson B, Aker PD, Goldsmith CH, Vernon H. A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain. Spine 2001;26(7):788-99.</ref> ==== | ==== Bronfort 2001<ref name="Bronfort 2001">Bronfort G, Evan R, Nelson B, Aker PD, Goldsmith CH, Vernon H. A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain. Spine 2001;26(7):788-99.</ref> ==== | ||
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Comparison (C) | Comparison (C) | ||
| T: PT: technique: 1% manipulation, 25% mobilization, 15% traction, 25% soft tissue treatment, 33% McKenzie treatment, 21% individual training, 15% transcutaneous electrical nerve stimulation/ ultrasound/ cold, 15% individual program, 6% relaxation training, 4% acupuncture, 1% instruction on individual training | | T: PT: technique: 1% manipulation, 25% mobilization, 15% traction, 25% soft tissue treatment, 33% McKenzie treatment, 21% individual training, 15% transcutaneous electrical nerve stimulation/ ultrasound/ cold, 15% individual program, 6% relaxation training, 4% acupuncture, 1% instruction on individual training | ||
C: Chiro technique: 97% manipulation, 11% mobilization, 2% traction, 2% soft tissue treatment, 1% individual training, frequency: mean 5.6 sessions over mean 4.9 weeks; dose: NR; route: cervical spine<br> | C: Chiro technique: 97% manipulation, 11% mobilization, 2% traction, 2% soft tissue treatment, 1% individual training, frequency: mean 5.6 sessions over mean 4.9 weeks; dose: NR; route: cervical spine<br> | ||
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| 5-6 weeks, <br>6-8 sessions<br> | | 5-6 weeks, <br>6-8 sessions<br> | ||
|- | |- | ||
! scope="row" | Follow-up | ! scope="row" | Follow-up | ||
| 52 weeks | | 52 weeks | ||
|} | |} | ||
Chiro: Chiropractic; PT: Physiotherapy. | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | *''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | ||
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*(b) Articular treatment including glenohumeral mobilization, thoracic mobilization, home exercises | *(b) Articular treatment including glenohumeral mobilization, thoracic mobilization, home exercises | ||
C: Wait-list control | C: Wait-list control<br> | ||
<br> | |||
|- | |- | ||
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*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Subacute.2Fchronic_neck_pain|''subacute/chronic neck pain'']] | *''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Subacute.2Fchronic_neck_pain|''subacute/chronic neck pain'']] | ||
==== Brodin | ==== Brodin 1984<ref name="Brodin 1984">Brodin H. Cervical pain and mobilization. Int J Rehabil Res 1984;7(2):190-1.</ref> ==== | ||
{| width="700" border="1" cellpadding="1" cellspacing="1" | {| width="700" border="1" cellpadding="1" cellspacing="1" | ||
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| T: Cervical mobilization, soft tissue treatment, stabilization exercise, relaxation techniques, non-steroidal anti-inflammatory, education | | T: Cervical mobilization, soft tissue treatment, stabilization exercise, relaxation techniques, non-steroidal anti-inflammatory, education | ||
C: Delayed Treatment Group | C: Delayed Treatment Group<br> | ||
<br> | |||
|- | |- | ||
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| T: Education, cervical manipulation, myofascial technique, exercise (spine stabilizing for cervical region and cervicothoracic junction) | | T: Education, cervical manipulation, myofascial technique, exercise (spine stabilizing for cervical region and cervicothoracic junction) | ||
C: Advice on simple regular exercise, done at own volition over 5 weeks | C: Advice on simple regular exercise, done at own volition over 5 weeks<br> | ||
<br> | |||
|- | |- | ||
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C: | C: | ||
*(a) Infrared radiation and advice on neck care | *(a) Infrared radiation and advice on neck care | ||
*(b) TENS and infrared radiation and advice on neck care | *(b) TENS and infrared radiation and advice on neck care | ||
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| 6 months | | 6 months | ||
|} | |} | ||
MRU: Multicervical rehab unit; TENS: Transelectrical nerve stimulation | |||
MRU: Multicervical rehab unit; TENS: Transelectrical nerve stimulation | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | *''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | ||
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| T: Physiotherapy protocol consisting of muscle stretching of neck and upper limbs regions, recruitment exercise of the deep neck flexors and strengthening exercise of deep neck flexors | | T: Physiotherapy protocol consisting of muscle stretching of neck and upper limbs regions, recruitment exercise of the deep neck flexors and strengthening exercise of deep neck flexors | ||
C: Acupuncture based on Traditional Chinese Medicine theory of biao-li (symptom/root) treatment<br> | C: Acupuncture based on Traditional Chinese Medicine theory of biao-li (symptom/root) treatment<br> | ||
|- | |- | ||
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*(a) Cervical/upper thoracic manipulation alone | *(a) Cervical/upper thoracic manipulation alone | ||
*(b) Attention control | *(b) Attention control | ||
<br> | |||
<br> | |||
|- | |- | ||
! scope="row" | Frequency | ! scope="row" | Frequency | ||
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|- | |- | ||
! scope="row" | Dose | ! scope="row" | Dose | ||
| 45 minute sessions | | 45 minute sessions | ||
*10 minsutes of typical qigong ‘opening’ exercises | *10 minsutes of typical qigong ‘opening’ exercises | ||
*25 minutes to perform up to 4 Dantian qigong exercises | *25 minutes to perform up to 4 Dantian qigong exercises | ||
*10 minutes of typical qigong ‘closing’ exercises | *10 minutes of typical qigong ‘closing’ exercises | ||
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! scope="row" | Dose | ! scope="row" | Dose | ||
| | | | ||
45 minute sessions | 45 minute sessions | ||
*Mobilizing and stabilizing the whole vertebrae is repeated 10-15 times | *Mobilizing and stabilizing the whole vertebrae is repeated 10-15 times | ||
*Strengthening the dorsal neck muscles is held for a few seconds and repeated 5 to 6 times | *Strengthening the dorsal neck muscles is held for a few seconds and repeated 5 to 6 times | ||
*Softening the atlanto-axial and upper vertebral joints is held for a few seconds and repeated 3-4 times each side | *Softening the atlanto-axial and upper vertebral joints is held for a few seconds and repeated 3-4 times each side | ||
*Strengthening the lateral neck muscles is repeated 3-4 times | *Strengthening the lateral neck muscles is repeated 3-4 times | ||
*Strengthening the ventral neck muscles is repeated 3-4 times | *Strengthening the ventral neck muscles is repeated 3-4 times | ||
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C: | C: | ||
*(a) Heat or cold and superficial massage | *(a) Heat or cold and superficial massage | ||
*(b) Neck support pillow; Heat or cold and superficial massage<br> | *(b) Neck support pillow; Heat or cold and superficial massage<br> | ||
|- | |- | ||
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C: | C: | ||
*(a) No treatment | *(a) No treatment | ||
*(b) Traction<br> | *(b) Traction<br> | ||
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| T: Eye-head coordination training and adjunct treatment | | T: Eye-head coordination training and adjunct treatment | ||
C: Adjunct non-steroidal anti-inflammatory and/or analgesic medications as necessary | C: Adjunct non-steroidal anti-inflammatory and/or analgesic medications as necessary<br> | ||
<br> | |||
|- | |- | ||
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| T: Cervical manipulation | | T: Cervical manipulation | ||
C: Wait list control <br> | C: Wait list control <br> | ||
|- | |- | ||
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|- | |- | ||
! scope="row" | Follow-up | ! scope="row" | Follow-up | ||
| | | 3 weeks | ||
|} | |} | ||
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=== Thoracic manipulation === | === Thoracic manipulation === | ||
==== Cleland 2007<ref | ==== Cleland 2007<ref>Cleland 2007</ref> ==== | ||
{| width="700" border="1" cellpadding="1" cellspacing="1" | {| width="700" border="1" cellpadding="1" cellspacing="1" | ||
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== Unspecified/mixed duration neck pain == | == Unspecified/mixed duration neck pain == | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to ''[[Neck Pain Tool-kit: Step 1|''Step 1: Identify your patient'']] | |||
=== Strengthening exercise === | === Strengthening exercise === | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']]<br> | ==== Andersen 2008<ref name="Andersen 2008">Andersen L, Kjaer M, Sogaard K, Hansen L, Kryger A and Sjogaard G. Effect of Two Contrasting Types of Physical Exercise on Chronic Neck Muscle Pain. Arthritis and Rheumatism 2008;59(1):84-91.</ref> ==== | ||
{| width="700" border="1" cellpadding="1" cellspacing="1" | |||
|- | |||
! scope="row" | | |||
Treatment (T) | |||
Comparison (C) | |||
| | |||
T: Strengthening of the neck and shoulders | |||
C: Health counseling<br> | |||
|- | |||
! scope="row" | Frequency | |||
| 3 sessions/week for 10 weeks | |||
|- | |||
! scope="row" | Dose | |||
| Progressive increases in load from 12 repetitions maximum (RM) (~70% of 1RM) to 8 repetitions maximum (~80% of 1RM). Training load was doubled by the end of 10 weeks. | |||
Exercises were performed using consecutive concentric and eccentric muscle contractions in a controlled manner without pause, each set lasting 25-30 seconds. | |||
30 repetitions of 5 different exercises were performed during each session. <br> | |||
|- | |||
! scope="row" | Duration | |||
| 10 weeks, Mean 26 sessions | |||
|- | |||
! scope="row" | Follow-up | |||
| 10 weeks | |||
|} | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Unspecified.2Fmixed_duration_neck_pain|''unspecified/mixed duration neck_pain'']]<br> | |||
== 4.2 Neck pain with cervicogenic headache == | == 4.2 Neck pain with cervicogenic headache == | ||
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=== Acute neck pain with cervicogenic headache === | === Acute neck pain with cervicogenic headache === | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize | *''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | ||
*''Click to return to ''[[Neck Pain Tool-kit: Step 1|''Step 1: Identify your patient'']] | |||
==== Manual therapy and relaxation and eye-fixation exercises ==== | ==== Manual therapy and relaxation and eye-fixation exercises ==== | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | ==== Provinciali 1996<ref name="Provinciali 1996">Provinciali L, Baroni M, Illuminati L, Ceravolo MG. Multimodal treatment to prevent the late whiplash syndrome. Scand J Rehabil Med 1996;28:105-11</ref> ==== | ||
{| width="700" border="1" cellpadding="1" cellspacing="1" | |||
|- | |||
! scope="row" | Disorder type | |||
| Acute, subacute neck pain with cervicogenic headache | |||
|- | |||
! scope="row" | | |||
Treatment (T) | |||
Comparison (C) | |||
| | |||
T: Cervical mobilization, massage, eye fixation exercise, neck school, relaxation using diaphragmatic breathing, psychological support<br> C: Transcutaneous electrical nerve stimulation, pulsed electromagnetic field, ultrasound<br> | |||
|- | |||
! scope="row" | Frequency | |||
| 5 sessions/week | |||
|- | |||
! scope="row" | Dose | |||
| 1 hour sessions | |||
|- | |||
! scope="row" | Duration | |||
| 2 weeks, <br>10 sessions | |||
|- | |||
! scope="row" | Follow-up | |||
| 24 weeks | |||
|} | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Acute/subacute neck pain with cervicogenic headachee|''acute/subacute neck pain with cervicogenic headache'']]<br> | |||
==== Self SNAG exercise ==== | ==== Self SNAG exercise ==== | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']]<br> | ==== Hall 2007<ref name="Hall 2007">Hall T, Chan H, Christensen L, Odenthal B, Wells C, Robinson K. Efficacy of a C1-C2 Self-sustained Natural Apophyseal Glide (SNAG) in the Management of Cervicogenic Headache. J Orthop Sports Phys Ther 2007;37(3):100-7.</ref> ==== | ||
{| width="700" border="1" cellpadding="1" cellspacing="1" | |||
|- | |||
! scope="row" | Disorder type | |||
| Acute/subacute cervicogenic headache | |||
|- | |||
! scope="row" | | |||
Treatment (T) | |||
Comparison (C) | |||
| T: C1/2 Self SNAG | |||
C: Sham: forward pressure on Self SNAG strap<br> | |||
|- | |||
! scope="row" | Frequency | |||
| 1 training session, <br>2 sessions/day for 1 year at home<br> | |||
|- | |||
! scope="row" | Dose | |||
| 2 repetitions, twice daily | |||
|- | |||
! scope="row" | Duration | |||
| 1 session | |||
|- | |||
! scope="row" | Follow-up | |||
| 4 weeks, 12 months<br> | |||
|} | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Acute.2Fsubacute_neck_pain_with_cervicogenic_headache|''acute/subacute neck pain with cervicogenic headache'']]<br> | |||
=== Chronic neck pain with cervicogenic headache === | === Chronic neck pain with cervicogenic headache === | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to ''[[Neck Pain Tool-kit: Step 1|''Step 1: Identify your patient'']] | |||
==== Manual therapy and exercise ==== | ==== Manual therapy and exercise ==== | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | ==== Jull 2002<ref name="Jull 2002" /> ==== | ||
{| width="700" border="1" cellpadding="1" cellspacing="1" | |||
|- | |||
! scope="row" | Disorder type | |||
| Chronic neck pain with cervicogenic headache | |||
|- | |||
! scope="row" | | |||
Treatment (T) | |||
Comparison (C) | |||
| | |||
T: Manipulation or mobilization and low load endurance exercise for cervicoscapular region<br> C: | |||
*(a) Exercise alone | |||
*(b) Manual therapy alone | |||
*(c) No treatment<br> | |||
|- | |||
! scope="row" | Frequency | |||
| 1-2 sessions/week | |||
|- | |||
! scope="row" | Dose | |||
| Treatment sessions: up to 30 minutes long<br>Manipulation or mobilization: not reported<br>Deep neck flexor exercises: twice/day<br>Scapulothoracic endurance exercises: twice/day<br>Postural correction exercises: regularly throughout the day | |||
|- | |||
! scope="row" | Duration | |||
| 6 weeks, <br>8-12 sessions<br> | |||
|- | |||
! scope="row" | Follow-up | |||
| 52 weeks | |||
|} | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Chronic_neck_pain_with_cervicogenic_headache|''Chronic neck pain with cervicogenic headache'']]<br> | |||
==== Exercise ==== | ==== Exercise ==== | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | ==== Jull 2002<ref name="Jull 2002" /> ==== | ||
{| width="700" border="1" cellpadding="1" cellspacing="1" | |||
|- | |||
! scope="row" | Disorder type | |||
| Chronic neck pain with cervicogenic headache | |||
|- | |||
! scope="row" | | |||
Treatment (T) | |||
Comparison (C) | |||
| | |||
T: Low load endurance for cervicoscapular region <br>Including deep neck flexor activation with pressure sensor, scapula retraction/adduction, postural correction, isometric resisted neck rotation, stretching<br> C: | |||
*(a) Manual therapy alone | |||
*(b) No treatment<br> | |||
|- | |||
! scope="row" | Frequency | |||
| 1-2 sessions/week | |||
|- | |||
! scope="row" | Dose | |||
| Treatment sessions: up to 30 minutes long<br>Deep neck flexor exercises: twice/day<br>Scapulothoracic endurance exercises: twice/day<br>Postural correction exercises: regularly throughout the day | |||
|- | |||
! scope="row" | Duration | |||
| 6 weeks, <br>8-12 sessions<br> | |||
|- | |||
! scope="row" | Follow-up | |||
| 52 weeks | |||
|} | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Chronic_neck_pain_with_cervicogenic_headache|''Chronic neck pain with cervicogenic headache'']]<br> | |||
==== Cervical manipulation ==== | ==== Cervical manipulation ==== | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | ==== Haas 2004<ref name="Haas 2004">Haas M, Groupp E, Aickin M, Fairweather A, Ganger B, Attwood M, et al.Dose response for chiropractic care of chronic cervicogenic headache and associated neck pain: A randomized pilot study. J Manipulative Physiol Ther 2004;27:547–53.</ref> ==== | ||
{| width="700" border="1" cellpadding="1" cellspacing="1" | |||
|- | |||
! scope="row" | Disorder type | |||
| Chronic neck pain with cervicogenic headache | |||
|- | |||
! scope="row" | | |||
Treatment (T) | |||
Comparison (C) | |||
| | |||
T: | |||
*(a) 12 sessions of manipulation, heat, soft tissue therapy with massage, trigger point therapy, education (modification of ADL), rehabilitation exercises | |||
*(b) 9 sessions of manipulation, heat, soft tissue therapy with massage, trigger point therapy, education (modification of ADL), rehabilitation exercises<br> | |||
C: | |||
*(c) 3 sessions of manipulation, heat, soft tissue therapy with massage, trigger point therapy, education (modification ofADL), rehabilitation exercises<br> | |||
|- | |||
! scope="row" | Frequency | |||
| | |||
*(a) 4 sessions/week | |||
*(b) 3 sessions/week | |||
*(c) 1 session/week | |||
|- | |||
! scope="row" | Dose | |||
| Not reported | |||
|- | |||
! scope="row" | Duration | |||
| 3 weeks, | |||
*(a) 12 sessions | |||
*(b) 9 sessions | |||
*(c) 3 sessions | |||
|- | |||
! scope="row" | Follow-up | |||
| 1 week,<br>11 weeks<br> | |||
|} | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Chronic_neck_pain_with_cervicogenic_headache|''Chronic neck pain with cervicogenic headache'']]<br> | |||
==== Chen 2007<ref name="Chen 2007">Chen L, Zhang XL, Ding H, Tao YQ, Zhan HS. Comparative study on effects of manipulation treatment and transcutaneous electrical nerve stimulation on patients with cervicogenic headache. Journal of Chinese Integrative Medicine 2007;5(4):403–6.</ref> ==== | |||
{| width="700" border="1" cellpadding="1" cellspacing="1" | |||
|- | |||
! scope="row" | Disorder type | |||
| | |||
Chronic neck pain with cervicogenic headache<br> | |||
|- | |||
! scope="row" | | |||
Treatment (T) | |||
Comparison (C) | |||
| | |||
T: Cervical manipulation<br>C: TENS <br> | |||
|- | |||
! scope="row" | Frequency | |||
| 10 sessions over 20 days | |||
|- | |||
! scope="row" | Dose | |||
| 20-30 minute treatment sessions | |||
|- | |||
! scope="row" | Duration | |||
| 3 weeks, <br>10 sessions<br> | |||
|- | |||
! scope="row" | Follow-up | |||
| 1 week | |||
|} | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Chronic_neck_pain_with_cervicogenic_headache|''Chronic neck pain with cervicogenic headache'']]<br> | |||
== 4.3 Whiplash associated disorder == | == 4.3 Whiplash associated disorder == | ||
Line 1,042: | Line 1,277: | ||
=== Acute/subacute whiplash associated disorder === | === Acute/subacute whiplash associated disorder === | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | *''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | ||
*''Click to return to ''[[Neck Pain Tool-kit: Step 1|''Step 1: Identify your patient'']] | |||
=== Manual therapy and exercise === | === Manual therapy and exercise === | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | ==== Giebel 1997<ref name="Giebel 1997">Giebel GD, Edelmann M, Huser R. Die distorsion der halswirbelsaule: Fruhfunktionalle vs. ruhigstellende behandlung. Zentralbibliotak Chiropractic 1997;122:517-21.</ref> ==== | ||
{| width="700" border="1" cellpadding="1" cellspacing="1" | |||
|- | |||
! scope="row" | Disorder type | |||
| Acute WAD with cervicogenic headache | |||
|- | |||
! scope="row" | | |||
Treatment (T) | |||
Comparison (C) | |||
| | |||
T: Cervical mobilization, passive movements under light traction; active, hold-relax/contract-relax technique to scaleni, levator scapula and trapezius in sitting; exercise; analgesic; anti-inflammatory<br>C: Collar: worn continuously, taken off at night; advised no exercise; analgesic; anti-inflammatory<br><br> | |||
|- | |||
! scope="row" | Frequency | |||
| Not reported | |||
|- | |||
! scope="row" | Dose | |||
| Not reported | |||
|- | |||
! scope="row" | Duration | |||
| 3 weeks | |||
|- | |||
! scope="row" | Follow-up | |||
| 9 weeks | |||
|} | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Acute.2Fsubacute_whiplash_associated_disorder|''acute/subacute whiplash associated disorder'']]<br> | |||
==== Mealy 1986<ref name="Mealy 1986">Mealy K, Brennan H, Fenelon GC. Early mobilization of acute whiplash injuries. Br Med J 1986;92:656-7.</ref> ==== | |||
{| width="700" border="1" cellpadding="1" cellspacing="1" | |||
|- | |||
! scope="row" | Disorder type | |||
| Acute WAD | |||
|- | |||
! scope="row" | | |||
Treatment (T) | |||
Comparison (C) | |||
| | |||
T: Cervical mobilization, exercise within the limits of pain, heat, ice, analgesics | |||
C: Soft cervical collar, worn for two weeks; rest for two weeks before beginning gradual mobilization, analgesics<br> | |||
|- | |||
! scope="row" | Frequency | |||
| Exercises performed daily, every hour at home | |||
|- | |||
! scope="row" | Dose | |||
| Not reported | |||
|- | |||
! scope="row" | Duration | |||
| 8 weeks | |||
|- | |||
! scope="row" | Follow-up | |||
| 0 | |||
|} | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Acute.2Fsubacute_whiplash_associated_disorder|''acute/subacute whiplash associated disorder'']]<br> | |||
==== Bonk 2000<ref name="Bonk 2000">Bonk AD, Ferrari R, Giebel GD, Edelmann M, Huser R. Prospective, randomized, controlled study of activity versus collar, and the natural history for whiplash injury, in Germany. J Musculoskelet Pain 2000;8(1/2):123-32.</ref> ==== | |||
{| width="700" border="1" cellpadding="1" cellspacing="1" | |||
|- | |||
! scope="row" | Disorder type | |||
| Acute WAD | |||
|- | |||
! scope="row" | | |||
Treatment (T) | |||
Comparison (C) | |||
| | |||
T: Cervical mobilization, isometric strengthening, inter scapular muscle strengthening, postural exercise, advice<br>C: Collar worn during day for 3 weeks, no physiotherapy, activity, exercise or mobilization<br><br> | |||
|- | |||
! scope="row" | Frequency | |||
| 3 sessions in first week, <br>2 sessions in second and third weeks<br> | |||
|- | |||
! scope="row" | Dose | |||
| Not reported | |||
|- | |||
! scope="row" | Duration | |||
| 3 weeks, <br>7 sessions<br> | |||
|- | |||
! scope="row" | Follow-up | |||
| 12 weeks | |||
|} | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Acute.2Fsubacute_whiplash_associated_disorder|''acute/subacute whiplash associated disorder'']]<br> | |||
==== McKinney 1994<ref name="McKinney 1994">McKinney MB. Behandlung der HWS-Distorsionen bei sog. Schleuderverletzungen. Orthopade 1994;23:287-90.</ref> ==== | |||
{| width="700" border="1" cellpadding="1" cellspacing="1" | |||
|- | |||
! scope="row" | Disorder type | |||
| Acute WAD | |||
|- | |||
! scope="row" | | |||
Treatment (T) | |||
Comparison (C) | |||
| | |||
T: Cervical mobilization, active and passive movements, heat/cold application, short wave diathermy, hydrotherapy, traction, education - posture and exercise to perform at home, standard analgesic, soft collar to be used intermittently | |||
C: (a) Education on mobilization after an initial 10-14 day rest period, general advice; analgesics; soft collar used continuously <br> (b) Education on posture correction, use of analgesics, use of collar when neck was vulnerable to sudden jolting, exercise performed after collar use, heat, muscle relaxation, encouraged to perform demonstrated mobilization exercises, analgesics<br> | |||
|- | |||
! scope="row" | Frequency | |||
| 3 sessions/week | |||
|- | |||
! scope="row" | Dose | |||
| 40 minute sessions | |||
|- | |||
! scope="row" | Duration | |||
| 6 weeks, <br>24 sessions<br> | |||
|- | |||
! scope="row" | Follow-up | |||
| 2 weeks | |||
|} | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Acute.2Fsubacute_whiplash_associated_disorder|''acute/subacute whiplash associated disorder'']]<br> | |||
==== Thoracic manipulation ==== | ==== Thoracic manipulation ==== | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']]<br> | ==== Fernandez-de-las-Penas 2004<ref name="Fernandez-de-las-Penas 2004">Fernandez-de-las-Penas C, Fernandez-Carnero J, Plaza Fernandez A, Lomas-Vega R, Miangolarra-Page JC. Dorsal manipulation in whiplash injury treatment: A randomized controlled trial. Journal of Whiplash & Related Disorders 2004;3:55–71.</ref> ==== | ||
{| width="700" border="1" cellpadding="1" cellspacing="1" | |||
|- | |||
! scope="row" | Disorder type | |||
| Acute, subacute WAD II or WAD III<br> | |||
|- | |||
! scope="row" | | |||
Treatment (T) | |||
Comparison (C) | |||
| | |||
T: Thoracic manipulation and adjunct treatment | |||
C: Adjunct treatment: Ultrasound, active exercise, muscle stretching, massage, electrotherapies, manual therapy<br> | |||
|- | |||
! scope="row" | Frequency | |||
| 2 manipulations over 2 weeks | |||
|- | |||
! scope="row" | Dose | |||
| 2 manipulations | |||
|- | |||
! scope="row" | Duration | |||
| 3 weeks, <br>15 sessions, manipulation at first two sessions<br> | |||
|- | |||
! scope="row" | Follow-up | |||
| 0 | |||
|} | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Acute.2Fsubacute_whiplash_associated_disorder|''acute/subacute whiplash associated disorder'']]<br> | |||
=== Chronic whiplash associated disorder === | === Chronic whiplash associated disorder === | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to ''[[Neck Pain Tool-kit: Step 1|''Step 1: Identify your patient'']] | |||
==== Manual therapy and exercise<br> ==== | ==== Manual therapy and exercise<br> ==== | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | ==== Jull 2007<ref name="Jull 2007">Jull G, Sterling M, Kenardy J, Beller E. Does the presence of sensory hypersensitivity influence outcomes of physical rehabilitation for chronic whiplash? A preliminary RCT. Pain 2007;129:28-34.</ref> ==== | ||
{| width="700" border="1" cellpadding="1" cellspacing="1" | |||
|- | |||
! scope="row" | Disorder type | |||
| Chronic WAD II | |||
|- | |||
! scope="row" | | |||
Treatment (T) | |||
Comparison (C) | |||
| | |||
T: Exercise, mobilizations, education, assurance | |||
C: Self management program including education on exercise, staying active, recovery process following WAD, ergonomic advice <br> | |||
|- | |||
! scope="row" | Frequency | |||
| 1-2 sessions/week<br> | |||
|- | |||
! scope="row" | Dose | |||
| Treatment sessions: up to 30 minutes long<br>Manipulation or mobilization: not reported<br>Deep neck flexor exercises: twice/day<br>Scapulothoracic endurance exercises: twice/day<br>Postural correction exercises: regularly throughout the day | |||
|- | |||
! scope="row" | Duration | |||
| 10 weeks,<br>10-15 sessions<br> | |||
|- | |||
! scope="row" | Follow-up | |||
| 0 | |||
|} | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Chronic_whiplash_associated_disorder|''chronic whiplash associated disorder'']]<br> | |||
== 4.4 Neck pain with radiculopathy == | == 4.4 Neck pain with radiculopathy == | ||
=== Acute neck pain with radiculopathy<br> === | === Acute neck pain with radiculopathy<br> === | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to ''[[Neck Pain Tool-kit: Step 1|''Step 1: Identify your patient'']] | |||
==== Mobilizing and stabilizing exercises ==== | ==== Mobilizing and stabilizing exercises ==== | ||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']]<br> | ==== Kuijper 2009<ref name="Kuijper 2009">Kuijper B., Tans JT, Beelen A., Nollet F. and de Visser M.. Cervical collar or physiotherpay versus wait and see policy for recent onset cervical radiculopathy: randomised trial. BMJ 2009;339(b3883).</ref> ==== | ||
{| width="700" border="1" cellpadding="1" cellspacing="1" | |||
|- | |||
! scope="row" | Disorder type | |||
| Acute neck pain with radiculopathy | |||
|- | |||
! scope="row" | | |||
Treatment (T) | |||
Comparison (C) | |||
| | |||
T: Mobilizing and stabilizing exercise <br>C: Wait list control and collar group<br> | |||
|- | |||
! scope="row" | Frequency | |||
| 2 sessions/week | |||
|- | |||
! scope="row" | Dose | |||
| Chest press in sitting: 2 x 10 repetitions with 5 kg.<br>Lateral Pull-down in sitting: 2 x 10 repetitions with 20 kg<br>Low-back flies: 2 x 10 repetitions with 1 kg <br>Neck-press: 2 x 10 repetitions with 1 kg<br>Front-raises: 2 x 10 repetitions with 1 kg<br>Upright row: 2 x 10 repetitions with 7.5 kg<br>Weight rotation: 3 repetitions: 5 repetitions to left and right with 7.5 kg<br>Home exercises: 2 sets of 10 repetitions each | |||
|- | |||
! scope="row" | Duration | |||
| 6 weeks, <br>12 sessions | |||
|- | |||
! scope="row" | Follow-up | |||
| 6 months | |||
|} | |||
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']] | |||
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Acute_neck_pain_with_radiculopathy|''acute neck pain with radiculopathy'']]<br> | |||
== References == | == References == |
Latest revision as of 10:57, 6 June 2017
This page is part of the 'Manual Therapy & Exercise for Neck Pain: Clinical Treatment Tool-kit' resource for clinical decision making, which provides evidence, techniques, and dosages for the use of manual therapy and exercise in the treatment of neck pain. Please see the main project page for further information, or to return to Step 1 to identify your patient. Otherwise, proceed to Step 4 below to consider dosage.
- The dosage corresponding to the techniques selected in step 3 is presented below, organized by patient characteristics
4.1 Neck pain alone
4.2 Neck pain with cervicogenic headache
4.3 Whiplash associated disorder
4.4 Neck pain with radiculopathy
- Once you have found the evidence most applicable to your patient, click on ‘Step 5- Individualize your treatment’ for other considerations in applying the evidence to your patient
4.1 Neck pain alone (non-specific)[edit | edit source]
Acute/subacute neck pain[edit | edit source]
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 1: Identify your patient
Thoracic manipulation[edit | edit source]
Cleland 2005[1][edit | edit source]
Disorder Type | Acute/subacute neck pain |
---|---|
Treatment (T) Comparison (C) |
T: Thoracic distraction manipulation + adjunct exercise C: Prone thoracic mobilization + adjunct exercise |
Frequency | 1 session |
Dose | 1-2 manipulations |
Duration | 1 session |
Follow-up | 0 |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for acute/subacute neck pain
Gonzalez-Iglesias 2009[2][edit | edit source]
Disorder Type | Acute neck pain |
---|---|
Treatment (T) Comparison (C) |
T: Seated thoracic distraction manipulation + adjunct treatment C: Adjunct treatment - ETT (infrared therapy + TENS) |
Frequency |
1 session/week of manipulation 5 sessions over 3 weeks of ETT |
Dose | 1-2 manipulations |
Duration | 3 weeks, 5 sessions |
Follow-up | 4 weeks |
ETT: Electrothermal therapy; TENS: Transelectrical nerve stimulation.
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for acute/subacute neck pain
Subacute/chronic neck pain[edit | edit source]
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 1: Identify your patient
Manual therapy and exercise[edit | edit source]
Bronfort 2001[3][edit | edit source]
Disorder Type | Chronic neck pain |
---|---|
Treatment (T) / Comparison (C) | T: Spinal manipulation and massage to the cervical and thoracic spine and exercise therapy C:
|
Frequency | 20 sessions over 11 weeks |
Dose | 15 minutes of manipulation and massage 45 minutes of exercise therapy Dumbbell shoulder exercises: 2 x 15-30 repetitions with 2-10lbs Pulley exercises: 1.25-10 lbs resistance |
Duration | 11 weeks, 20 sessions |
Follow-up | 52 and 104 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Hoving 2002[4][edit | edit source]
Disorder Type | Neck pain of mixed duration with or without cervicogenic headache or radiculopathy |
---|---|
Treatment (T) / Comparison (C) | T: Muscular and articular mobilization techniques to the cervical spine, coordination and stabilization techniques C:
|
Frequency | 1 session/week |
Dose | 45 minute treatment sessions, exercise and manual therapy dosage not reported |
Duration | Max. 6 weeks, 3-6 session |
Follow-up | 52 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Jull 2002[5]
[edit | edit source]
Disorder Type | Chronic neck pain with cervicogenic headache |
---|---|
Treatment (T) / Comparison (C) | T: Manipulation or mobilization and low load endurance exercise for cervicoscapular region C:
|
Frequency | 1-2 sessions/week |
Dose | Treatment sessions: up to 30 minutes long Deep neck flexor exercises: twice/day Postural correction exercises: regularly throughout the day |
Duration | 6 weeks, 8-12 sessions |
Follow-up | 52 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Skargren 1998[6][edit | edit source]
Disorder Type | Chronic neck pain |
---|---|
Treatment (T) Comparison (C) |
T: PT: technique: 1% manipulation, 25% mobilization, 15% traction, 25% soft tissue treatment, 33% McKenzie treatment, 21% individual training, 15% transcutaneous electrical nerve stimulation/ ultrasound/ cold, 15% individual program, 6% relaxation training, 4% acupuncture, 1% instruction on individual training
C: Chiro technique: 97% manipulation, 11% mobilization, 2% traction, 2% soft tissue treatment, 1% individual training, frequency: mean 5.6 sessions over mean 4.9 weeks; dose: NR; route: cervical spine |
Frequency | Mean 7.5 sessions over 6.4 weeks |
Dose | Not reported |
Duration | 5-6 weeks, 6-8 sessions |
Follow-up | 52 weeks |
Chiro: Chiropractic; PT: Physiotherapy.
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Ylinen 2003[7][edit | edit source]
Disorder Type | Chronic neck pain |
---|---|
Treatment (T) Comparison (C) |
T:
C: Control (aerobics and stretching) |
Frequency |
|
Dose | 45 minute exercise sessions
|
Duration | 2 weeks, 10 sessions |
Follow-up | 12 months |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Allison 2002[8][edit | edit source]
Disorder Type | Neck pain with mechanically sensitive neural tissue |
---|---|
Treatment (T) Comparison (C) |
T:
C: Wait-list control |
Frequency | Not reported |
Dose | Active movements at home performed 10 repetitions, 1-3 times/day |
Duration | 8 weeks |
Follow-up | 0 |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Brodin 1984[9][edit | edit source]
Disorder Type | Chronic neck pain with or without radicular findings |
---|---|
Treatment (T) Comparison (C) |
T: Passive mobilizations, massage, manual traction, heat, analgesics, education
C:
|
Frequency | 3 sessions/week |
Dose | Not reported |
Duration | 9 sessions, 3 weeks |
Follow-up | 1 week |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Karlberg 1996[10][edit | edit source]
Disorder Type | Subacute neck pain with dizziness |
---|---|
Treatment (T) Comparison (C) |
T: Cervical mobilization, soft tissue treatment, stabilization exercise, relaxation techniques, non-steroidal anti-inflammatory, education
C: Delayed Treatment Group |
Frequency | Median 13 sessions over median 13 weeks |
Dose | Not reported |
Duration | 5-23 sessions, 5-20 weeks |
Follow-up | 0 |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Palmgren 2006[11][edit | edit source]
Disorder Type | Chronic neck pain |
---|---|
Treatment (T) Comparison (C) |
T: Education, cervical manipulation, myofascial technique, exercise (spine stabilizing for cervical region and cervicothoracic junction)
C: Advice on simple regular exercise, done at own volition over 5 weeks |
Frequency | 3-5 sessions over 5 weeks |
Dose | Not reported |
Duration | 3-5 sessions, 5 weeks |
Follow-up | 0 |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Strengthening exercise[edit | edit source]
Chiu 2005[12][edit | edit source]
Disorder Type | Subacute neck pain |
---|---|
Treatment (T) Comparison (C) |
T: DNF with pressure sensor, C spine MRU at 30% max isometric strength, increased by 5% when able to do 12 reps, and infrared radiation and advice on neck care
C:
|
Frequency | 2 sessions/week |
Dose | Warm-up : one set (10 minutes) of deep neck flexor activation and one set of 15 repetitions at 20% on Deep neck flexor activation: 10s hold, 15 s rest for 10 min MRU: 3 sets of 8 to 12 reps of flexion and extension progressive starting at 30% isometric maximum Each session lasted 35 minutes |
Duration | 6 weeks, 12 sessions |
Follow-up | 6 months |
MRU: Multicervical rehab unit; TENS: Transelectrical nerve stimulation
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Bronfort 2001[3][edit | edit source]
Disorder Type | Chronic neck pain |
---|---|
Treatment (T) Comparison (C) |
T: Exercise therapy using MedX equipment
C:
|
Frequency | 20 sessions over 11 weeks |
Dose | Warm-up: aerobic exercise for 15-20 minutes, stretching and upper body strengthening Progressive exercises: performed on the MedX equipment to volitional fatigue up to 20 repetitions |
Duration | 11 weeks, 20 sessions |
Follow-up | 52 and 104 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Franca 2008[13][edit | edit source]
Disorder Type | Chronic neck pain |
---|---|
Treatment (T) Comparison (C) |
T: Physiotherapy protocol consisting of muscle stretching of neck and upper limbs regions, recruitment exercise of the deep neck flexors and strengthening exercise of deep neck flexors
C: Acupuncture based on Traditional Chinese Medicine theory of biao-li (symptom/root) treatment |
Frequency | 1-2 sessions/week |
Dose | 20 minute treatment sessions |
Duration | 10 weeks, 20 sessions |
Follow-up | 6 months |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Martel 2011[14][edit | edit source]
Disorder Type | Chronic neck pain |
---|---|
Treatment (T) Comparison (C) |
T: Cervical/upper thoracic manipulation and exercise
C:
|
Frequency | 1 session/month |
Dose | 10-15 minute treatment. Maximum 4 manipulations. Advised to perform a home exercise program 3 times/week. 3 series of each exercises with a 30-60 second rest between series were performed during each training session. A training session lasted 20-30 minutes. All participants were instructed in the same routine, exerise volume was tailored to each participant's strength, flexibility and ability to complete the routine with minimal neck pain. Each patient received a written copy of the program. Exercise checked every 2 months by a kinesiologist. |
Duration | 10 months, 10 sessions |
Follow-up | 0 |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Qigong exercises[edit | edit source]
Rendant 2011[15][edit | edit source]
Treatment (T) Comparison (C) |
T: Qigong exercises
C: No treatment control |
---|---|
Frequency | 18 sessions over 6 months |
Dose | 90 minute sessions |
Duration | 6 months, 18 sessions |
Follow-up | 0 |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
von Trott 2009[16][edit | edit source]
Treatment (T) Comparison (C) |
T: Qigong lessons
C: Wait-list control |
---|---|
Frequency | 2 sessions/week |
Dose | 45 minute sessions
|
Duration | 3 months, 24 sessions |
Follow-up | 0 |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Cervical range of motion and strengthening exercise[edit | edit source]
Rendant 2011[15][edit | edit source]
Treatment (T) Comparison (C) |
T: Exercise C: No treatment control |
---|---|
Frequency | 18 sessions over 6 months |
Dose | 90 minute sessions |
Duration | 6 months, 18 sessions |
Follow-up | 0 |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
von Trott 2009[16][edit | edit source]
Treatment (T) Comparison (C) |
T: Exercise therapy based on a standardized program for computer and workplace related neck pain C: Wait-list control
|
---|---|
Frequency | 2 sessions/week |
Dose |
45 minute sessions
|
Duration | 3 months, 24 sessions |
Follow-up | 0 |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Isometric strengthening[edit | edit source]
Helewa 2007[17][edit | edit source]
Disorder Type | Subacute, chronic neck pain |
---|---|
Treatment (T) Comparison (C) |
T: Active neck and postural exercises, neck support pillow, heat or cold and superficial massage
C:
|
Frequency | 2 sessions/week for 3 weeks; 1 session/week for 3 weeks; 1 final session at 10 weeks; |
Dose | Exercises were performed twice/day for 5-10 minutes |
Duration | 10 weeks; 7-10 sessions |
Follow-up | 2 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Goldie 1970[18][edit | edit source]
Disorder Type | Chronic Neck pain with possible radiculopathy |
---|---|
Treatment (T) Comparison (C) |
T: Maximal pain free isometric strengthening of the cervical spine in sitting and supine against PT manual resistance
C:
|
Frequency | 3 sessions/week |
Dose | 20 minute treatment sessions |
Duration | 3 weeks, 10 sessions |
Follow-up | 3 weeks, 24 week by letter |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Eye-neck coordination exercises[edit | edit source]
Revel 1994[19][edit | edit source]
Disorder Type | Chronic neck pain |
---|---|
Treatment (T) Comparison (C) |
T: Eye-head coordination training and adjunct treatment
C: Adjunct non-steroidal anti-inflammatory and/or analgesic medications as necessary |
Frequency | 2 sessions/week |
Dose | 30-40 minute treatment sessions |
Duration | 8 weeks, 15 sessions |
Follow-up | 10 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Cervical manipulation[edit | edit source]
Bitterli 1997[20][edit | edit source]
Disorder Type | Chronic neck pain with headache or degenerative changes |
---|---|
Treatment (T) Comparison (C) |
T: Cervical manipulation
C: Wait list control |
Frequency | 1 session/week |
Dose | Mean 6.2 manipulations over 3.2 sessions |
Duration | 3 weeks, 3 sessions |
Follow-up | 12 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Howe 1983[21][edit | edit source]
Disorder Type | Subacute/chronic neck pain with radicular findings and cervicogenic headache |
---|---|
Treatment (T) Comparison (C) |
T: Cervical manipulation
C: Azapropazone
|
Frequency | 1 session |
Dose | 17/26 patients received 1 manipulation 4/26 received 2 manipulations 2/26 received 3 manipulations 1/26 received manipulation of the neck and low back 2/26 received injection of either methylprednisone or lignocaine and hydrocortisone to the dorsum of the appropriate apophyseal joint and manipulation |
Duration | 1 session |
Follow-up | 3 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Martinez-Segura 2006[22][edit | edit source]
Disorder Type | Subacute, chronic neck pain |
---|---|
Treatment (T) Comparison (C) |
T: Cervical manipulation: ipsilateral side flexion, contralateral rotation
C: Sham: neck positioned into ipsilateral side flexion, contralateral rotation, position held for 30 second, the side of manual contact was randomised
|
Frequency | 1 session |
Dose | 1 manipulation |
Duration | 1 session |
Follow-up | 0 |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Sloop 1982[23][edit | edit source]
Disorder Type | Subacute, chronic neck pain |
---|---|
Treatment (T) Comparison (C) |
T: Cervical manipulation and adjunct treatment
C: Adjunct diazepam
|
Frequency | 1 session |
Dose | 1 manipulation |
Duration | 1 session |
Follow-up | 3 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Vernon 1990[24][edit | edit source]
Disorder Type | Neck pain of mixed duration |
---|---|
Treatment (T) Comparison (C) |
T: Cervical rotational manipulation
C: Rotational mobilization with gentle oscillations into
|
Frequency | 1 session |
Dose | Not reported |
Duration | 1 session |
Follow-up | 0 |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Thoracic manipulation[edit | edit source]
Cleland 2007[25][edit | edit source]
Disorder Type | Chronic neck pain |
---|---|
Treatment (T) Comparison (C) |
T: thoracic distraction manipulation
C: Placebo manipulation
|
Frequency | 1 session |
Dose | 1-2 manipulations per segment identified average 3.7 manipulations/subject |
Duration | 1 session |
Follow-up | 0 |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for subacute/chronic neck pain
Unspecified/mixed duration neck pain[edit | edit source]
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 1: Identify your patient
Strengthening exercise[edit | edit source]
Andersen 2008[26][edit | edit source]
Treatment (T) Comparison (C) |
T: Strengthening of the neck and shoulders C: Health counseling |
---|---|
Frequency | 3 sessions/week for 10 weeks |
Dose | Progressive increases in load from 12 repetitions maximum (RM) (~70% of 1RM) to 8 repetitions maximum (~80% of 1RM). Training load was doubled by the end of 10 weeks.
Exercises were performed using consecutive concentric and eccentric muscle contractions in a controlled manner without pause, each set lasting 25-30 seconds. 30 repetitions of 5 different exercises were performed during each session. |
Duration | 10 weeks, Mean 26 sessions |
Follow-up | 10 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for unspecified/mixed duration neck_pain
4.2 Neck pain with cervicogenic headache[edit | edit source]
Acute neck pain with cervicogenic headache[edit | edit source]
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 1: Identify your patient
Manual therapy and relaxation and eye-fixation exercises[edit | edit source]
Provinciali 1996[27][edit | edit source]
Disorder type | Acute, subacute neck pain with cervicogenic headache |
---|---|
Treatment (T) Comparison (C) |
T: Cervical mobilization, massage, eye fixation exercise, neck school, relaxation using diaphragmatic breathing, psychological support |
Frequency | 5 sessions/week |
Dose | 1 hour sessions |
Duration | 2 weeks, 10 sessions |
Follow-up | 24 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for acute/subacute neck pain with cervicogenic headache
Self SNAG exercise[edit | edit source]
Hall 2007[28][edit | edit source]
Disorder type | Acute/subacute cervicogenic headache |
---|---|
Treatment (T) Comparison (C) |
T: C1/2 Self SNAG
C: Sham: forward pressure on Self SNAG strap |
Frequency | 1 training session, 2 sessions/day for 1 year at home |
Dose | 2 repetitions, twice daily |
Duration | 1 session |
Follow-up | 4 weeks, 12 months |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for acute/subacute neck pain with cervicogenic headache
Chronic neck pain with cervicogenic headache[edit | edit source]
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 1: Identify your patient
Manual therapy and exercise[edit | edit source]
Jull 2002[5][edit | edit source]
Disorder type | Chronic neck pain with cervicogenic headache |
---|---|
Treatment (T) Comparison (C) |
T: Manipulation or mobilization and low load endurance exercise for cervicoscapular region
|
Frequency | 1-2 sessions/week |
Dose | Treatment sessions: up to 30 minutes long Manipulation or mobilization: not reported Deep neck flexor exercises: twice/day Scapulothoracic endurance exercises: twice/day Postural correction exercises: regularly throughout the day |
Duration | 6 weeks, 8-12 sessions |
Follow-up | 52 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for Chronic neck pain with cervicogenic headache
Exercise[edit | edit source]
Jull 2002[5][edit | edit source]
Disorder type | Chronic neck pain with cervicogenic headache |
---|---|
Treatment (T) Comparison (C) |
T: Low load endurance for cervicoscapular region
|
Frequency | 1-2 sessions/week |
Dose | Treatment sessions: up to 30 minutes long Deep neck flexor exercises: twice/day Scapulothoracic endurance exercises: twice/day Postural correction exercises: regularly throughout the day |
Duration | 6 weeks, 8-12 sessions |
Follow-up | 52 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for Chronic neck pain with cervicogenic headache
Cervical manipulation[edit | edit source]
Haas 2004[29][edit | edit source]
Disorder type | Chronic neck pain with cervicogenic headache |
---|---|
Treatment (T) Comparison (C) |
T:
C:
|
Frequency |
|
Dose | Not reported |
Duration | 3 weeks,
|
Follow-up | 1 week, 11 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for Chronic neck pain with cervicogenic headache
Chen 2007[30][edit | edit source]
Disorder type |
Chronic neck pain with cervicogenic headache |
---|---|
Treatment (T) Comparison (C) |
T: Cervical manipulation |
Frequency | 10 sessions over 20 days |
Dose | 20-30 minute treatment sessions |
Duration | 3 weeks, 10 sessions |
Follow-up | 1 week |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for Chronic neck pain with cervicogenic headache
4.3 Whiplash associated disorder[edit | edit source]
Acute/subacute whiplash associated disorder[edit | edit source]
- Click to continue to Step 5: Individualize treatment
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Manual therapy and exercise[edit | edit source]
Giebel 1997[31][edit | edit source]
Disorder type | Acute WAD with cervicogenic headache |
---|---|
Treatment (T) Comparison (C) |
T: Cervical mobilization, passive movements under light traction; active, hold-relax/contract-relax technique to scaleni, levator scapula and trapezius in sitting; exercise; analgesic; anti-inflammatory |
Frequency | Not reported |
Dose | Not reported |
Duration | 3 weeks |
Follow-up | 9 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for acute/subacute whiplash associated disorder
Mealy 1986[32][edit | edit source]
Disorder type | Acute WAD |
---|---|
Treatment (T) Comparison (C) |
T: Cervical mobilization, exercise within the limits of pain, heat, ice, analgesics C: Soft cervical collar, worn for two weeks; rest for two weeks before beginning gradual mobilization, analgesics |
Frequency | Exercises performed daily, every hour at home |
Dose | Not reported |
Duration | 8 weeks |
Follow-up | 0 |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for acute/subacute whiplash associated disorder
Bonk 2000[33][edit | edit source]
Disorder type | Acute WAD |
---|---|
Treatment (T) Comparison (C) |
T: Cervical mobilization, isometric strengthening, inter scapular muscle strengthening, postural exercise, advice |
Frequency | 3 sessions in first week, 2 sessions in second and third weeks |
Dose | Not reported |
Duration | 3 weeks, 7 sessions |
Follow-up | 12 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for acute/subacute whiplash associated disorder
McKinney 1994[34][edit | edit source]
Disorder type | Acute WAD |
---|---|
Treatment (T) Comparison (C) |
T: Cervical mobilization, active and passive movements, heat/cold application, short wave diathermy, hydrotherapy, traction, education - posture and exercise to perform at home, standard analgesic, soft collar to be used intermittently C: (a) Education on mobilization after an initial 10-14 day rest period, general advice; analgesics; soft collar used continuously |
Frequency | 3 sessions/week |
Dose | 40 minute sessions |
Duration | 6 weeks, 24 sessions |
Follow-up | 2 weeks |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for acute/subacute whiplash associated disorder
Thoracic manipulation[edit | edit source]
Fernandez-de-las-Penas 2004[35][edit | edit source]
Disorder type | Acute, subacute WAD II or WAD III |
---|---|
Treatment (T) Comparison (C) |
T: Thoracic manipulation and adjunct treatment C: Adjunct treatment: Ultrasound, active exercise, muscle stretching, massage, electrotherapies, manual therapy |
Frequency | 2 manipulations over 2 weeks |
Dose | 2 manipulations |
Duration | 3 weeks, 15 sessions, manipulation at first two sessions |
Follow-up | 0 |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for acute/subacute whiplash associated disorder
Chronic whiplash associated disorder[edit | edit source]
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 1: Identify your patient
Manual therapy and exercise
[edit | edit source]
Jull 2007[36][edit | edit source]
Disorder type | Chronic WAD II |
---|---|
Treatment (T) Comparison (C) |
T: Exercise, mobilizations, education, assurance C: Self management program including education on exercise, staying active, recovery process following WAD, ergonomic advice |
Frequency | 1-2 sessions/week |
Dose | Treatment sessions: up to 30 minutes long Manipulation or mobilization: not reported Deep neck flexor exercises: twice/day Scapulothoracic endurance exercises: twice/day Postural correction exercises: regularly throughout the day |
Duration | 10 weeks, 10-15 sessions |
Follow-up | 0 |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for chronic whiplash associated disorder
4.4 Neck pain with radiculopathy[edit | edit source]
Acute neck pain with radiculopathy
[edit | edit source]
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 1: Identify your patient
Mobilizing and stabilizing exercises[edit | edit source]
Kuijper 2009[37][edit | edit source]
Disorder type | Acute neck pain with radiculopathy |
---|---|
Treatment (T) Comparison (C) |
T: Mobilizing and stabilizing exercise |
Frequency | 2 sessions/week |
Dose | Chest press in sitting: 2 x 10 repetitions with 5 kg. Lateral Pull-down in sitting: 2 x 10 repetitions with 20 kg Low-back flies: 2 x 10 repetitions with 1 kg Neck-press: 2 x 10 repetitions with 1 kg Front-raises: 2 x 10 repetitions with 1 kg Upright row: 2 x 10 repetitions with 7.5 kg Weight rotation: 3 repetitions: 5 repetitions to left and right with 7.5 kg Home exercises: 2 sets of 10 repetitions each |
Duration | 6 weeks, 12 sessions |
Follow-up | 6 months |
- Click to continue to Step 5: Individualize treatment
- Click to return to Step 3: Inform your technique for acute neck pain with radiculopathy
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ Cleland JA, Childs Maj JD, McRae M, Palmer JA, Stowell T. Immediate effects of a thoracic manipulation in patients with neck pain: A randomized clinical trial. Manual Therapy 2005;10: 127–35.
- ↑ Gonzalez-Iglesias J, Fernandez-De-Las-Penas C, Cleland JA, Del Rosario Gutierrez-Vega M. Thoracic spine manipulation for the management of paitents with neck pain: a randomized clinical trial. J Orthop Sports Phys Ther 2009;39(1):20–7.
- ↑ 3.0 3.1 Bronfort G, Evan R, Nelson B, Aker PD, Goldsmith CH, Vernon H. A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain. Spine 2001;26(7):788-99.
- ↑ Hoving JL, Koes BW, de Vet HCW, van der Windt DAWM, Assendelft WJJ, van Mameren H, et al. Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain. A randomized controlled trial. Ann Int Med 2002;136:713-22.
- ↑ 5.0 5.1 5.2 Jull G, Trott P, Potter H, Zito G, Niere K, Shirley D, et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine 2002;27(17):1835-43.
- ↑ Skargren EI, Carlsson PG, Oberg BE. One-year follow-up comparison of the cost and effectiveness of chiropractic and physiotherapy as primary management for back pain. Spine 1998;23(17):1875-84.
- ↑ Ylinen J, Takala EP, Nykanen M, Hakkinen A, Malkia E, Pohjolainen T, et al. Active neck muscle training in the treatment of chronic neck pain in women. JAMA 2003;289(19):2509-16.
- ↑ Allison GT, Nagy BM, Hall T. A randomized clinical trial of manual therapy for cervico-brachial pain syndrome e a pilot study. Man Ther 2002;7 (2):95-102.
- ↑ Brodin H. Cervical pain and mobilization. Int J Rehabil Res 1984;7(2):190-1.
- ↑ Karlberg M, Magnusson M, Eva-Maj M, Melander A, Moritz U. Postural and symptomatic improvement after physiotherapy in patients with dizziness of suspected cervical origin. Arch Phys Med Rehabil 1996;77:874-82.
- ↑ Palmgren PJ, Sandstrom PJ, Lundqvist FJ, Heikkila H. Improvement after chiropractic care in cervicocephalic kinesthetic sensibility and subjective pain intensity in patients with nontraumatic chronic neck pain. J Manipulative Physiol Ther 2006;29:100-6.
- ↑ Chiu T, Huiu-Chan C, and Cheing G. A randomized clinical trial of TENS and exercise for patients with chronic neck pain. Clin Rehabil 2005;19:850-60.
- ↑ Franca DLM., Senna-Fernades V., Martins Cortez C., Jackson MN., Bernardo-Filho M., and Guimaraes MAM. Tension neck syndrome treated by acupuncture combined with physiotherapy: A comparative clinical trial (pilot study). Complementary Therapies in Medicine 2008;16:268-277.
- ↑ Martel J., Dugas C., Dubois JD., Descarreaux M.. A randomised controlled trial of preventive spinal manipulation with and without a home exercise program for patients with chronic neck pain. BMC Musculoskeletal Disorders 2011;12:41-54.
- ↑ 15.0 15.1 Rendant D, Pach D, Ludtke R, Reishauer A, Mietzner A, Willich SN, Witt CM. Qigong versus exercise versus no therapy for patients with chronic neck pain. Spine 2011;36(6):419-29.
- ↑ 16.0 16.1 von Trott P., Wiedemann A, Ludtke R., reibhauer A., Willich ST., and Witt CM.. Qigong and exercise therapy for elderly patients with chronic neck pain (QIBANE): A randomized controlled study. J Pain 2009;10(5):501-508.
- ↑ Helewa A, Goldsmith C, Smythe H, Lee P, Obright K. Effect of Therapuetic esercise and Sleeping Neck Support on Patients with Chronic Neck Pain: A Randomized Clinical Trial. J Rheumatol 2007;34(1):151-58.
- ↑ Goldie I, Landquist A. Evaluation of the effects of different forms of physiotherapy in cervical pain. Scand J Rehab Med 1970;2-3:117-21.
- ↑ Revel M, Minguet M, Gergoy P, Vaillant J, Manuel JL. Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck apin: a randomized controlled study. Arch Phys Med Rehabil 1994;75:895-9.
- ↑ Bitterli J, Graf R, Robert F, Adler R, Mumenthaler M. Zur objectivierung der manualtherapeutischen beeinflussbarkeit des spondylogenen kopfschmerzes. Nervenarzt 1977;48:259–62.
- ↑ Howe DH, Newcombe RG, Wade MT. Manipulation of the cervical spine - a pilot study. Journal of the Royal College of General Practitioners 1983;33:574–9.
- ↑ Martinez-Segura R, Fernandez-de-las-Penas C, Ruiz-Saez M, Lopez-Jimenez C, Rodriguez-Blanco C. Immedicate effects on neck pain and active range of motion after a single cervical high-velocity low amplitude manipulation in subjects presenting with mechanical neck pain: A randomized controlled trial. J Manipulative Phyiol Ther 2006;29:511–7.
- ↑ Sloop PR, Smith DS, Goldenberg E, Dore C. Manipulation for chronic neck pain: A double-blind controlled study. Spine 1982;7 (6):532–5.
- ↑ Vernon HT, Aker P, Burns S, Viljakaanen S, Short L. Pressure pain threshold evaluation of the effect of spinal manipulation in the treatment of chronic neck pain: A pilot study. J Manipulative Physiol Ther 1990;13(1):13–6.
- ↑ Cleland 2007
- ↑ Andersen L, Kjaer M, Sogaard K, Hansen L, Kryger A and Sjogaard G. Effect of Two Contrasting Types of Physical Exercise on Chronic Neck Muscle Pain. Arthritis and Rheumatism 2008;59(1):84-91.
- ↑ Provinciali L, Baroni M, Illuminati L, Ceravolo MG. Multimodal treatment to prevent the late whiplash syndrome. Scand J Rehabil Med 1996;28:105-11
- ↑ Hall T, Chan H, Christensen L, Odenthal B, Wells C, Robinson K. Efficacy of a C1-C2 Self-sustained Natural Apophyseal Glide (SNAG) in the Management of Cervicogenic Headache. J Orthop Sports Phys Ther 2007;37(3):100-7.
- ↑ Haas M, Groupp E, Aickin M, Fairweather A, Ganger B, Attwood M, et al.Dose response for chiropractic care of chronic cervicogenic headache and associated neck pain: A randomized pilot study. J Manipulative Physiol Ther 2004;27:547–53.
- ↑ Chen L, Zhang XL, Ding H, Tao YQ, Zhan HS. Comparative study on effects of manipulation treatment and transcutaneous electrical nerve stimulation on patients with cervicogenic headache. Journal of Chinese Integrative Medicine 2007;5(4):403–6.
- ↑ Giebel GD, Edelmann M, Huser R. Die distorsion der halswirbelsaule: Fruhfunktionalle vs. ruhigstellende behandlung. Zentralbibliotak Chiropractic 1997;122:517-21.
- ↑ Mealy K, Brennan H, Fenelon GC. Early mobilization of acute whiplash injuries. Br Med J 1986;92:656-7.
- ↑ Bonk AD, Ferrari R, Giebel GD, Edelmann M, Huser R. Prospective, randomized, controlled study of activity versus collar, and the natural history for whiplash injury, in Germany. J Musculoskelet Pain 2000;8(1/2):123-32.
- ↑ McKinney MB. Behandlung der HWS-Distorsionen bei sog. Schleuderverletzungen. Orthopade 1994;23:287-90.
- ↑ Fernandez-de-las-Penas C, Fernandez-Carnero J, Plaza Fernandez A, Lomas-Vega R, Miangolarra-Page JC. Dorsal manipulation in whiplash injury treatment: A randomized controlled trial. Journal of Whiplash & Related Disorders 2004;3:55–71.
- ↑ Jull G, Sterling M, Kenardy J, Beller E. Does the presence of sensory hypersensitivity influence outcomes of physical rehabilitation for chronic whiplash? A preliminary RCT. Pain 2007;129:28-34.
- ↑ Kuijper B., Tans JT, Beelen A., Nollet F. and de Visser M.. Cervical collar or physiotherpay versus wait and see policy for recent onset cervical radiculopathy: randomised trial. BMJ 2009;339(b3883).