Neck Pain Tool-kit: Step 4: Difference between revisions

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=== Thoracic manipulation  ===
=== Thoracic manipulation  ===


*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'']]


==== Cleland 2007<ref name="Cleland 2007" />  ====
==== Cleland 2007<ref name="Cleland 2007" />  ====
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*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 Step 3: Inform your technique for [[Neck Pain Tool-kit: Step 3#Acute.2Fsubacute_neck_pain|acute/subacute neck pain]]
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Acute.2Fsubacute_neck_pain|''acute/subacute neck pain'']]


==== Gonzalez-Iglesias 2009<ref name="Gonzalez-Iglesias 2009">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.</ref>  ====
==== Gonzalez-Iglesias 2009<ref name="Gonzalez-Iglesias 2009">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.</ref>  ====
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ETT: Electrothermal therapy; TENS: Transelectrical nerve stimulation.  
ETT: Electrothermal therapy; 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'']]
*Click to return to Step 3: Inform your technique for [[Neck Pain Tool-kit: Step 3#Acute.2Fsubacute_neck_pain|acute/subacute neck pain]]<br>
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Acute.2Fsubacute_neck_pain|''acute/subacute neck pain'']]<br>


== Subacute/chronic neck pain  ==
== Subacute/chronic neck pain  ==
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=== Manual therapy and exercise  ===
=== Manual therapy and exercise  ===


*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'']]


==== 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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*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 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'']]


==== Hoving 2002<ref name="Hoving 2002">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.</ref>  ====
==== Hoving 2002<ref name="Hoving 2002">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.</ref>  ====
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*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 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'']]


==== Jull 2002<ref name="Jull 2002">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.</ref><br>  ====
==== Jull 2002<ref name="Jull 2002">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.</ref><br>  ====
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*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 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'']]


==== Skargren 1998<ref name="Skargren 1998">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.</ref>  ====
==== Skargren 1998<ref name="Skargren 1998">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.</ref>  ====
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*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 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'']]


==== Ylinen 2003<ref name="Ylinen 2003">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.</ref>  ====
==== Ylinen 2003<ref name="Ylinen 2003">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.</ref>  ====
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*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 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'']]


==== Allison 2002<ref name="Allison 2002">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.</ref>  ====
==== Allison 2002<ref name="Allison 2002">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.</ref>  ====
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*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 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 1982<ref name="Brodin 1982" />  ====
==== Brodin 1982<ref name="Brodin 1982" />  ====
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*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 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'']]


==== Karlberg 1996<ref name="Karlberg 1996">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.</ref>  ====
==== Karlberg 1996<ref name="Karlberg 1996">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.</ref>  ====
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*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 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'']]


==== Palmgren 2006<ref name="Palmgren 2006">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.</ref>  ====
==== Palmgren 2006<ref name="Palmgren 2006">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.</ref>  ====
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*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 Step 3: Inform your technique for [[Neck Pain Tool-kit: Step 3#Subacute.2Fchronic_neck_pain|subacute/chronic neck pain]]<br>
*''Click to return to Step 3: Inform your technique for ''[[Neck Pain Tool-kit: Step 3#Subacute.2Fchronic_neck_pain|''subacute/chronic neck pain'']]<br>


=== Strengthening exercise  ===
=== Strengthening exercise  ===
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*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 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'']]


==== Franca 2008<ref name="Franca 2008">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.</ref>  ====
==== Franca 2008<ref name="Franca 2008">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.</ref>  ====
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*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 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'']]


==== Martel 2011<ref name="Martel 2011">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.</ref>  ====
==== Martel 2011<ref name="Martel 2011">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.</ref>  ====
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*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 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'']]


=== Qigong exercises  ===
=== Qigong exercises  ===


==== 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>  ====
==== Rendant 2011<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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*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 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'']]


==== 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>  ====
==== von Trott 2009<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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*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 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'']]


=== Cervical range of motion and strengthening exercise  ===
=== Cervical range of motion and strengthening 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>  ====
==== Rendant 2011<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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*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 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'']]


==== 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>  ====
==== von Trott 2009<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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| Chronic neck pain
| <br>
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Treatment (T)  


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Comparison (C)  


| T:&nbsp;<br>C:  
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*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 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'']]


=== Isometric strengthening  ===
=== Isometric strengthening  ===


==== 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> ====
==== Helewa 2007 ====


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*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 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'']]


==== 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> ====
==== Goldie 1970 ====


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*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 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'']]


=== Eye-neck coordination exercises  ===
=== Eye-neck coordination exercises  ===


==== 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> ====
==== Revel 1994 ====


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*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 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'']]


=== Cervical manipulation  ===
=== Cervical manipulation  ===


==== 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> ====
==== Bitterli 1997 ====


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*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 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'']]


==== 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> ====
==== Howe 1983 ====


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*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 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'']]


==== 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> ====
==== Martinez-Segura 2006 ====


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*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 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'']]


==== 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> ====
==== Sloop 1982 ====


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*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 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'']]


==== 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> ====
==== Vernon 1990 ====


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Comparison (C)  


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| T:&nbsp;<br>C:  
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<br>  


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*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 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'']]


=== Thoracic manipulation  ===
=== Thoracic manipulation  ===


==== 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> ====
==== Cleland 2007 ====


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*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 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'']]<br>
 
*Click to continue to [[Neck Pain Tool-kit: Step 5|Step 5: Individualize treatment]]


== Unspecified/mixed duration neck pain  ==
== Unspecified/mixed duration neck pain  ==
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=== Strengthening exercise  ===
=== Strengthening exercise  ===


*Click to continue to [[Neck Pain Tool-kit: Step 5|Step 5: Individualize treatment]]<br>
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']]<br>


== 4.2 Neck pain with cervicogenic headache  ==
== 4.2 Neck pain with cervicogenic headache  ==
Line 986: Line 984:
=== 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 treatment]]
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatmen''t]]


==== 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]]
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']]


==== Self SNAG exercise  ====
==== Self SNAG exercise  ====


*Click to continue to [[Neck Pain Tool-kit: Step 5|Step 5: Individualize treatment]]<br>
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']]<br>


=== Chronic&nbsp;neck pain with cervicogenic headache  ===
=== Chronic&nbsp;neck pain with cervicogenic headache  ===
Line 1,000: Line 998:
==== Manual therapy and exercise  ====
==== Manual therapy and exercise  ====


*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'']]


==== Exercise  ====
==== Exercise  ====


*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'']]


==== Cervical manipulation  ====
==== Cervical manipulation  ====


*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'']]


== 4.3 Whiplash associated disorder  ==
== 4.3 Whiplash associated disorder  ==
Line 1,014: Line 1,012:
=== Acute/subacute&nbsp;whiplash associated disorder  ===
=== Acute/subacute&nbsp;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'']]


=== Manual therapy and exercise ===
=== Manual therapy and exercise ===


*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'']]


==== Thoracic manipulation ====
==== Thoracic manipulation ====


*Click to continue to [[Neck Pain Tool-kit: Step 5|Step 5: Individualize treatment]]<br>
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']]<br>


=== Chronic&nbsp;whiplash associated disorder  ===
=== Chronic&nbsp;whiplash associated disorder  ===
Line 1,028: Line 1,026:
==== Manual therapy and exercise<br>  ====
==== Manual therapy and exercise<br>  ====


*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'']]


== 4.4 Neck pain with radiculopathy  ==
== 4.4 Neck pain with radiculopathy  ==
Line 1,036: Line 1,034:
==== Mobilizing and stabilizing exercises  ====
==== Mobilizing and stabilizing exercises  ====


*Click to continue to [[Neck Pain Tool-kit: Step 5|Step 5: Individualize treatment]]<br>
*''Click to continue to ''[[Neck Pain Tool-kit: Step 5|''Step 5: Individualize treatment'']]<br>


== References  ==
== References  ==

Revision as of 11:12, 11 April 2012

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.


NeckPainToolkit Step4 Logo.png

  • 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]

Thoracic manipulation[edit | edit source]

Cleland 2007[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

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.

Subacute/chronic neck pain[edit | edit source]

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:
  • (a) Exercise therapy using MedX equipment
  • (b) Spinal manipulation and massage + detuned microcurrent
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

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:
  • (a) Active exercise therapies: strengthening, stretching (ROM), postural/ relaxation/ functional exercise; optional modalities: manual traction, massage, interferential current, heat
  • (b) Continued care by a general practitioner including advice on prognosis, psychosocial issues, self-care, ergonomics and awaiting further recovery; an educational booklet on ergonomics and exercise; medication including paracetamol or nonsteroidal anti-inflammatory if necessary
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

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:
  • (a) Exercise alone
  • (b) Manual therapy alone
  • (c) No treatment
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

Skargren 1998[6][edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T : Physiotherapy (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: Chiropractic (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

Ylinen 2003[7][edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T:

  • (a) Endurance training group: neck flexion by lifting head up from supine; upper extremity exercises using dumbbells; lower extremity exercises using body weight; aerobic exercise 3 times/week; multimodal rehabilitation program including: relaxation, aerobic training, behavioural support, ergonomics, 4 sessions of physiotherapy including mobilization and massage
  • (b) Strength training group: using elastic resistance to flexion and oblique flexion/side flexion; upper extremity exercises using dumbbells; lower extremity exercises using body weight; aerobic exercise 3 times/week; multimodal rehabilitation program including: relaxation, aerobic training, behavioural support, ergonomics, 4 sessions of physiotherapy including mobilization and massage

C: Control (aerobics and stretching)

Frequency
  • Exercises:
    • 5 sessions/week for 2 weeks;
    • 3 times/week for 1 year at home
  • Physical therapy:
    • 4 sessions over 2 weeks
Dose 45 minute exercise sessions
  • (a) Endurance training group: 3 sets of 20 repetitions; using 2kg dumbbells for upper extremity exercises
  • (b) Strength training group: 1 set of 15 repetitions; using 80% maximum isometric strength for band exercises; using individualized resistance for dumbbell exercises using the highest load possible for 15 repetitions
Duration 2 weeks,
10 sessions
Follow-up 12 months

Allison 2002[8][edit | edit source]

Disorder Type Neck pain with mechanically sensitive neural tissue

Treatment (T)

Comparison (C)

T:
  • (a) Neural treatment including cervical lateral glide, shoulder girdle oscillation, contract/relax techniques, and active movements at home
  • (b) Articular treatment including glenohumeral mobilization, thoracic mobilization, home exercises

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

Brodin 1982[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:

  • (a) Mock therapy including massage, manual traction, electrical stimulation, analgesics, education
  • (b) Analgesics
Frequency 3 sessions/week
Dose Not reported
Duration 9 sessions,
3 weeks
Follow-up 1 week

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

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

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 multicervical rehab unit (MRU) at 30% max isometric strength, increased by 5% when able to do 12 reps, and infrared radiation and advice on neck care

C: (a) Infrared radiation and advice on neck care
(b) TENS and infrared radiation and advice on neck care


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

Bronfort 2001[3][edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T: Exercise therapy using MedX equipment

C:

  • (a) Spinal manipulation and massage to the cervical and thoracic spine and exercise therapy
  • (b) Spinal manipulation and massage + detuned microcurrent


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

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

Martel 2011[14][edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T: Cervical/upper thoracic manipulation and exercise

C:

  • (a) Cervical/upper thoracic manipulation alone
  • (b) Attention control
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

Qigong exercises[edit | edit source]

Rendant 2011[3][edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T: 
C:


Frequency 2
Dose 15e
Duration 11 
Follow-up 5

von Trott 2009[3][edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T: 
C:


Frequency 2
Dose 15e
Duration 11 
Follow-up 5

Cervical range of motion and strengthening exercise[edit | edit source]

Rendant 2011[3][edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T: 
C:


Frequency 2
Dose 15e
Duration 11 
Follow-up 5

von Trott 2009[3][edit | edit source]

Disorder Type

Treatment (T)

Comparison (C)

T: 
C:


Frequency 2
Dose 15e
Duration 11 
Follow-up 5

Isometric strengthening[edit | edit source]

Helewa 2007[edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T: 
C:


Frequency 2
Dose 15e
Duration 11 
Follow-up 5

Goldie 1970[edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T: 
C:


Frequency 2
Dose 15e
Duration 11 
Follow-up 5

Eye-neck coordination exercises[edit | edit source]

Revel 1994[edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T: 
C:


Frequency 2
Dose 15e
Duration 11 
Follow-up 5

Cervical manipulation[edit | edit source]

Bitterli 1997[edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T: 
C:


Frequency 2
Dose 15e
Duration 11 
Follow-up 5

Howe 1983[edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T: 
C:


Frequency 2
Dose 15e
Duration 11 
Follow-up 5

Martinez-Segura 2006[edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T: 
C:


Frequency 2
Dose 15e
Duration 11 
Follow-up 5

Sloop 1982[edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T: 
C:


Frequency 2
Dose 15e
Duration 11 
Follow-up 5

Vernon 1990[edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T: 
C:


Frequency 2
Dose 15e
Duration 11 
Follow-up 5

Thoracic manipulation[edit | edit source]

Cleland 2007[edit | edit source]

Disorder Type Chronic neck pain

Treatment (T)

Comparison (C)

T: 
C:


Frequency 2
Dose 15e
Duration 11 
Follow-up 5

Unspecified/mixed duration neck pain[edit | edit source]

Strengthening exercise[edit | edit source]

4.2 Neck pain with cervicogenic headache[edit | edit source]

Acute neck pain with cervicogenic headache[edit | edit source]

Manual therapy and relaxation and eye-fixation exercises[edit | edit source]

Self SNAG exercise[edit | edit source]

Chronic neck pain with cervicogenic headache[edit | edit source]

Manual therapy and exercise[edit | edit source]

Exercise[edit | edit source]

Cervical manipulation[edit | edit source]

4.3 Whiplash associated disorder[edit | edit source]

Acute/subacute whiplash associated disorder[edit | edit source]

Manual therapy and exercise[edit | edit source]

Thoracic manipulation[edit | edit source]

Chronic whiplash associated disorder[edit | edit source]

Manual therapy and exercise
[edit | edit source]

4.4 Neck pain with radiculopathy[edit | edit source]

Acute neck pain with radiculopathy
[edit | edit source]

Mobilizing and stabilizing exercises[edit | edit source]

References[edit | edit source]

References will automatically be added here, see adding references tutorial.

  1. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named Cleland 2007
  2. ↑ 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. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 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.
  4. ↑ 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. ↑ 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.
  6. ↑ 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.
  7. ↑ 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.
  8. ↑ 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.
  9. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named Brodin 1982
  10. ↑ 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.
  11. ↑ 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.
  12. ↑ 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.
  13. ↑ 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.
  14. ↑ 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.
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