Evidence Based Interventions for Neck Pain
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Introduction[edit | edit source]
Once any signs of potentially serious disease are excluded, the physiotherapist can confidently consider the condition to be suitable for physiotherapy management. When managing individuals with neck pain clinicians should consider implementing approaches based on risk, impairment, or response to treatment when choosing their interventions.
Education[edit | edit source]
Education plays a great role in the management of individuals with neck pain[1] and this may be the most important and most challenging part of the treatment. The physiotherapist needs to provide a careful explanation to reassure the patient that no serious disease or injury has been found. Great care is needed to select appropriate, non-threatening words that will not be misinterpreted by the patient[2] and providing biomechanical information about the spine that is not evidence-based can add to their concerns[3]. It is important to avoid reinforcing individuals fears about the threatening processes that might be going on in their spine as these fears or concerns can act as a barrier to recovery and need to be properly addressed[3].
An essential component of treatment for individuals with neck pain is to encourage active self-management. The primary aim is to help patients resume normal activities as far as possible, as soon as possible.
Advice can be effectively supported by offering simple evidence-based educational materials.
Exercise Therapy[edit | edit source]
Exercise-based neck/shoulder rehabilitation can be an effective way of managing cervicogenic disorders. No one exercise regime stands out although there is some evidence that both strengthening and endurance regimes have superior benefits over other forms of activity, such as stretching programmes or returning to normal activity[1]. Multimodal treatment approaches that include the use of exercise therapy appear to be more effective than single treatments alone for the management of neck pain
Motor control
Sensorimotor
Passive Treatments[edit | edit source]
Manual Therapy[edit | edit source]
- Contraindications and red flags for manual therapy - https://www.clinicaledge.co/podcast/5-minute-physio-tips/5-minute-physio-tip-contraindications-and-red-flags-to-cervical-spine-manual-therapy
- Evidence for manual therapy in the cervical spine - https://www.clinicaledge.co/podcast/5-minute-physio-tips/5-minute-physio-tip-manual-therapy-for-the-cervical-spine-is-there-any-evidence
Soft Tissue Mobilisation[edit | edit source]
Physical Modalities[edit | edit source]
Psychosocial Aspects[edit | edit source]
There is evidence that psychosocial factors (yellow flags) are more important than biomechanical factors in influencing the development of neck pain. Psychosocial factors play an important role in persisting symptoms and disability, and influence the response to treatment and rehabilitation. Barriers to recovery need to be identified and addressed.
cognitive–behavioural interventions can be successful but the extent of training and the resulting skill levels that are required to deliver an effective cognitive behavioural intervention may be critical[4].
References[edit | edit source]
- ↑ 1.0 1.1 Rebbeck T. The Role of Exercise and Patient Education in the Noninvasive Management of Whiplash: A Clinical Commentary. Journal of Orthopaedic & Sports Physical Therapy. 2017 Jun 16(0):1-32.
- ↑ Bedell SE, Graboys TB, Bedell E, Lown B. Words that harm, words that heal. Arch Intern Med 2004; 164:1365–8.
- ↑ 3.0 3.1 Moffett J, McLean S. The role of physiotherapy in the management of non-specific back pain and neck pain. Rheumatology. 2005 Dec 6;45(4):371-8.
- ↑ Moffett J, McLean S. The role of physiotherapy in the management of non-specific back pain and neck pain. Rheumatology. 2005 Dec 6;45(4):371-8.
