Neck Pain Tool-kit: Step 2
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 2 below to determine the evidence.
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- The evidence regarding the use of manual therapy and exercise for the treatment of neck pain is presented below, organized by patient characteristics
- Once you have found the evidence most applicable to your patient, click on ‘Step 3-inform your technique’ to see the techniques utilized in the positive studies for that patient population
2.1 Neck pain alone (non-specific)[edit | edit source]
Acute/subacute neck pain
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Manual therapy
Author, year of original studies | Participant characteristics | Intervention | Comparison | Pain | Function/ Disability | GPE | Patient Satisfaction | QoL |
---|---|---|---|---|---|---|---|---|
Cleland 2007 | Acute/subacute neck pain | Thoracic manipulation + adjunct treatment | Thoracic mobilization + adjunct exercise | ▲▲ | ▲▲ | ▲▲ | ||
Gonzalez-Iglesias 2009[1] |
Acute neck pain | Thoracic manipulation + adjunct treatment | Adjunct electrothermal therapy | ▲, ▲▲ | ▲, ▲▲ | |||
Egwu 2008[2] | Acute/subacute neck pain | Ipsilateral PA or AP mobilization | Rotation or transverse mobilization | ∆ |
AP: Anterior-posterior; GPE: Global perceived effect; QoL: Quality of life; PA: Posterior-anterior.
- Now go back to Step 1: Identify your patient, or continue to Step 3: Inform your technique.
Subacute/chronic neck pain
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Manual Therapy and Exercise
Author, year of original studies | Participant characteristics | Intervention | Comparison |
Pain | Function/ Disability | GPE | Patient Satisfaction | QoL |
---|---|---|---|---|---|---|---|---|
Bronfort 2001[3], Hoving 2002[4], Jull 2002[5] | Subacute/chronic neck pain with or without CGH | Manipulation or mobilization and exercise | Primarily exercise alone | ♦♦, ◊◊◊◊ |
◊◊, ◊◊◊◊ |
◊◊, ◊◊◊◊ |
◊◊, ◊◊◊◊ | |
Bronfort 2001[3], Skargren 1998[6] | Chronic neck pain | Manipulation or mobilization and exercise | Primarily manipulation or mobilization alone | ●●●● |
●●●● | |||
Ylinen 2003[7] | Chronic neck pain | Manipulation, mobilization, and exercise | Adjunct advice including general exercise | ●●●● | ●●●● | |||
Allison 2002[8], Brodin 1985[9], Jull 2002[5], Karlberg 1996[10] | Subacute/chronic neck pain with or without CGH or Radiculopathy | Manipulation or mobilization and exercise | No treatment | ▲, ▲▲, ▲▲▲▲ | ||||
Palmgren 2006[11] | Chronic neck pain | Manipulation or mobilization and exercise | Advice | ▲ | ||||
Hoving 2002[4], Walker 2008[12] | Chronic or mixed duration neck pain | Manipulation or mobilization and exercise | Traditional care | ○○○○ | ||||
Persson 2001[13] | Chronic neck pain with radicular symptoms | Manipulation or mobilization and exercise | Collar therapy or surgery | ∆ | ||||
Vasseljen 1995[14] | Chronic neck pain | Manipulation or mobilization and exercise | Exercise | ∆∆∆ |
AP: Anterior-posterior; CGH: Cervicogenic headache; GPE: Global perceived effect; QoL: Quality of life; PA: Posterior-anterior.
- Now go back to Step 1: Identify your patient, or continue to Step 3: Inform your technique.
Exercise
Author, year of original studies | Participant characteristics | Intervention | Comparison |
Pain | Function/ Disability | GPE | Patient Satisfaction | QoL |
---|---|---|---|---|---|---|---|---|
Chiu 2005[15], Evans 2002[16], Franca 2008[17], Martel 2011[18] | Chronic neck pain |
Combined cervical and scapulothoracic stretching and strengthening + adjunct treatment |
Adjunct treatment (varied) |
♦, ●●, ♦♦♦, ○○○○ |
♦, ●●, ♦♦♦, ●●●● |
●, ○○, ○○○, ○○○○ |
●, ●●, ●●●, ●●●● |
○, ○○, ○○○, ○○○○ |
Von Trott 2009[19], Rendent 2011 | Chronic neck pain | Qigong exercises (Dantian Qigong) |
Wait list control |
●, ●● |
●, ●● |
○, ○○ |
●, ●● | |
Von Trott 2009[19], Rendent 2011 | Chronic neck pain |
Cervical range of motion and strengthening exercise |
Wait list control |
▲, ▲▲ |
▲, ▲▲ |
∆, ∆∆ | ∆, ∆∆ | |
Helewa 2007[20] | Chronic neck pain | Isometric neck exercises + adjunct treatment |
Adjunct pillow |
▲, ▲▲ |
▲, ▲▲ | ▲, ▲▲ | ||
Goldie 1970[21], Helewa 2007[20] | Chronic neck pain |
Isometric neck exercises |
No treatment |
∆, ∆∆ |
∆, ∆∆ | ▲ | ∆, ∆∆ | |
Revel 1994[22] | Chronic neck pain |
Eye neck coordination exercises + adjunct treatment |
Adjunct medication |
▲▲ |
▲▲ | |||
Viljanen 2006[23] | Chronic neck pain with/without WAD |
Upper extremity stretching and endurance training |
Normal activities |
○, ○○, ○○○○ |
○, ○○, ○○○○ | |||
Kjellman 2002[24] | Chronic neck pain |
Neck and upper extremity stretch and strengthening program |
Sham ultrasound |
∆, ∆∆, ∆∆∆, ∆∆∆∆ |
∆, ∆∆, ∆∆∆, ∆∆∆∆ | |||
Kjellman 2002[24] | Chronic neck pain |
Cervical movement exercises (McKenzie) |
Sham ultrasound |
∆, ∆∆, ∆∆∆, ∆∆∆∆ |
∆, ∆∆, ∆∆∆, ∆∆∆∆ | |||
Allan 2003[25] | Chronic neck pain |
Stretching exercises either before or after a manipulation |
That same manipulation |
∆ |
∆ | |||
Lundblad 1999[26] |
Chronic neck pain |
Stabilization of the low back and pelvis, posture awareness, ergonomic training, and strength, coordination, endurance, flexibility/smoothness and rhythm exercises |
No treatment |
∆∆ |
GPE: Global perceived effect; QoL: Quality of life; WAD: Whiplash-associated disorder.
- Now go back to Step 1: Identify your patient, or continue to Step 3: Inform your technique.
Manual therapy
Author, year of original studies | Participant characteristics | Intervention | Comparison |
Pain | Function/ Disability | GPE | Patient Satisfaction | QoL |
---|---|---|---|---|---|---|---|---|
Bitterli 1977[27], Howe 1983[28], Martinez-Segura 2006[29], Sloop 1982[30], Vernon 1990[31] | Subacute/chronic neck pain |
Cervical manipulation |
Various controls |
▲, ▲▲ |
||||
Cleland 2005[32] | Chronic neck pain |
Thoracic manipulation |
Sham manipulation |
▲ |
||||
Kanlayanaphotporn 2010[33] | Chronic neck pain |
Central PA mobilization |
One of three random mobilizations |
▲ |
∆ |
|||
Hurwitz 2002 | Subacute to chronic neck pain with or without CGH or radiculopathy |
Cervical manipulation |
Cervical mobilization |
○○○ |
○○○ |
|||
Kanlayanaphotporn 2009 | Chronic neck pain |
Ipsilateral PA mobilization |
Randomly selected ipsilateral/central/ contralateral PA mobilization |
∆ |
∆ |
|||
Strunk 2008 | Subacute or chronic neck pain |
Cervical mobilization |
Manipulation to various spinal regions |
∆ |
||||
Giles 1999, Muller 2005 | Chronic neck pain |
Cervical manipulation |
medication |
∆ |
∆ |
|||
Giles 1999, Muller 2005 | Chronic neck pain |
Cervical manipulation |
Acupuncture or electroacupuncture |
∆ |
∆ |
|||
Yurkiw 1996, Wood 2001 | Subacute neck pain |
Manual cervical manipulation |
Activator instrumental manipulation |
∆, ∆∆ |
∆, ∆∆ |
|||
David 1998 | Chronic neck pain with or without WAD |
Cervical mobilization |
Acupuncture |
∆∆∆∆ |
∆∆∆∆ |
|||
Bitterli 1977 | Chronic neck pain with or without CGH | Cervical mobilization |
Adjunct cervical manipulation |
∆ |
CGH: Cervicogenic headache; GPE: Global perceived effect; QoL: Quality of life; PA: Posterior-anterior; WAD: Whiplash-associated disorder.
- Now go back to Step 1: Identify your patient, or continue to Step 3: Inform your technique.
Unspecified/mixed duration neck pain[edit | edit source]
Exercise
Manual therapy
2.2 Neck pain with cervicogenic headache[edit | edit source]
Acute/subacute neck pain with cervicogenic headache[edit | edit source]
Manual therapy and exercise[edit | edit source]
Exercise[edit | edit source]
Manual therapy[edit | edit source]
Chronic neck pain with cervicogenic headache[edit | edit source]
Manual therapy and exercise[edit | edit source]
Exercise[edit | edit source]
Manual therapy[edit | edit source]
2.3 Whiplash associated disorder[edit | edit source]
Acute/subacute whiplash associated disorder[edit | edit source]
Manual therapy and exercise[edit | edit source]
Exercise[edit | edit source]
Manual therapy[edit | edit source]
Chronic whiplash associated disorder[edit | edit source]
Manual therapy and exercise
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2.4 Neck pain with radiculopathy[edit | edit source]
Acute neck pain with radiculopathy
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Exercise[edit | edit source]
Manual therapy
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References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ 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.
- ↑ Eqwu MO. Relative therapeutic efficacy of some vertebral mobolization techniques in the management of unilateral cervical spondylosis: a comparitive study. J Phys Ther Sci 2008;20:103-8.
- ↑ 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.
- ↑ 4.0 4.1 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 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. Man Med 1985;2:18-22.
- ↑ 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.
- ↑ Walker MJ, Boyles RE, Young BA, Strunce JB, Garber MB, Whitman JM, et al. The effectiveness of manual physical therapy and exercise for mechanical neck pain. Spine 2008;33(22):2371-8.
- ↑ Persson LCG, Lilja A. Pain, coping, emotional state and physical function in patients with chronic radicular neck pain. A comparison between patients treated with surgery, physiotherapy or neck collar a blinded, prospective randomized study. Disabil Rehabil 2001;23(8):325-35.
- ↑ Vasseljen O, Johansen BM, Westgaard RH. The effect of pain reduction on perceived tension and EMG-recoded trapezius muscle activity in workers with shoulder and neck pain. Scand J Rehabil Med 1995;27:243-52.
- ↑ 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.
- ↑ Evans R, Bronfort G, Nelson B, Goldsmith C. Two-year follow-up of a randomized clinical trial of spinal manipulation and two types of exercise for patients with chronic neck pain. Spine 2002;27:2383-9.
- ↑ 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). Complement Ther Med 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 Musculoskelet Disord 2011;12:41-54.
- ↑ 19.0 19.1 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.
- ↑ 20.0 20.1 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. The 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.
- ↑ Viljanen M, Malmivaara A, Uitti J, Rinne M, Palmroos P and Laippala. Effectiveness of dynamic muscle training, relaxation training, or ordinary activity for chronic neck pain: randomized controlled trial. BMJ 2003;327:475-480.
- ↑ 24.0 24.1 Kjellman, G and Oberg B. A randomized clinical trial comparing general exercise, Mckenzie treatment and a control group in patients with neck pain. J Rehabil Med 2002;34:183-190.
- ↑ Allan M, Brantingham JW, Menezes A. Stretching as an adjunct to chiropractic manipulation of chronic neck pain - before, after or not at all? A prospective randomized controlled clinical trial. Eur J Chiropr 2003;50:41-52.
- ↑ Lundblad I, Elert J, Gerdle B. Randomized controlled trial of physiotherapy and feldenkrais interventions in female workers with neck-shoulder complaints. J Occup Rehabil 1999;9(3):179-94.
- ↑ 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. J R Coll Gen Pract 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 Physiol 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 Therapeutics 1990;13(1):13-6.
- ↑ 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. Man Ther 2005;10:127–35.
- ↑ Kanlayanaphotporn R, Chiradejnant A, Vachalathiti R. Immediated effects of the central posteroanterior mobilization technique on pain and range of motion in patients with mechanical neck pain. Disability and Rehabilitation Disabil Rehabil 2010;32(8):622-8.