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Glendale Adventist Medical Center
1500 E. Chevy Chase Drive, Suite 401B
Glendale, CA 91206
Ph: (818) 863-4444

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Best Treatment Practice for Chronic Neck Pain

Posted on: 03/20/2008
If you are suffering from chronic neck pain, there are many treatment approaches to choose from. There are medications to relieve pain, exercise, heat, electrical stimulation, and collars. Physical therapists and chiropractors offer manual therapy (joint mobilization and manipulation). And there's acupuncture, laser and magnetic therapy, or a combination of any of these methods just listed.

Which one works best? Which combination is the most effective? Patients rely on their doctor to guide them. But how does a doctor decide? Researchers conduct a best evidence review of all the articles published on a topic such as neck pain. They summarize the data and offer conclusions and guidelines.

Physicians and other health care providers depend on systematic reviews such as this one. They look for advice on best practice. They are especially interested in cost and cost-benefit when helping prevent and manage conditions such as neck pain.

The authors of this review looked at all the articles on the course and care of neck pain published between 1980 and 2006. Treatment was always conservative. This means it was noninvasive (did not involve injections or surgery). Here are a few of their key findings:

  • Mobilization and exercise have the best results both for whiplash-associated disorders (WAD) and neck disorders without trauma.
  • Manual therapy, supervised exercise programs, low-level laser therapy, and acupuncture are better than no therapy. They seem to have equal benefit so that no one treatment approach came out ahead of the others.
  • Too much treatment can actually delay or slow down a patient's recovery from whiplash.
  • Not much was found on the subject of cost effectiveness. More research is needed into this area.

    Scientists have only begun to scratch the surface in finding a good solution that's safe and cost effective for neck pain. It seems that for the most part, patients with neck pain have about the same results with or without most treatment.

    There may be a best combination of treatments that are most effective, but it's not clear what that is. Even programs aimed at education and prevention don't seem to have any effect at reducing chronic or recurring neck pain.

    The authors suggest further studies are needed to expand our understanding of neck pain. In particular, high-quality research needs to be done in the areas of self-care approaches, prevention, and cost- and risk-benefit of individual therapies.

  • References:
    Eric L. Hurwitz, DC, PhD, et al. Treatment of Neck Pain: Noninvasive Interventions. In Spine. Supplement to February 15, 2008. Vol. 33. No. 4S. Pp. S123-S152.

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