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Supervised Exercise Therapy for Neck Pain May Help Pain, Range of Motion

Posted on: 11/30/1999
Neck pain, a common complaint in the Western world, can have a significant impact on quality of life. Many treatments have been tried, including physiotherapy, which included hands-on massage to treatment with therapeutic devices. Exercise therapy, a common approach to neck pain treatment, can include exercise for mobilization, strengthening, stretching, and endurance, with the aim to improving function, reducing pain, and increasing the patient's awareness of what triggers the neck pain.

The authors of this study investigated the effectiveness of exercise therapy combined with Qigong, a therapeutic Chinese practice that involves slow movements and breathing exercises, combined with meditation. One hundred twenty two patients with neck pain participated in this prospective, randomized controlled trial. The patients, aged between 18 and 65 years, had non-specific neck pain of at least three months and a Visual Analog Score (VAS) of at least 20. VAS is measured on a scale of one to 100, zero indicating no pain, 100 indicating severest pain. Patients with chronic tension-type headaches, migraines, traumatic neck injuries, neurological signs, rheumatic disease, fibromyalgia, or other severe physiologic or physical diseases, or receiving treatment with antidepressants or anti-inflammatories were all excluded from the study.

Of the 122 patients (86 women), 60 were randomized to qigong and the remaining 62 to exercise therapy. Both groups were seen one to two times per week over a three-month period for a total of 10 to 12 visits. Both groups were also given ergonomic instructions, which included information regarding neck pain.

The patients in the qigong group were seen in groups of 10 to 15, with each session beginning with information about the philosophy of the practice and instruction for the exercises, following a guideline of 14 exercises. The patients in the exercise group participated in individually adjusted programs that involved resistance and repetitions.

All patients were evaluated at the start of the study, after the treatment, at six months following the study beginning and again at 12 months after. They were assessed by VAS for pain intensity and the patients kept a pain diary for the first week. The Neck Disability Index (NDI) was used to assess function and activity; grip strength was assessed by an instrument called the Grippit, and the neck range of motion was assessed with a Murin goniometer. The findings of the 102 patients who completed the study, were as follows: neck pain frequency before treatment was rated in the qigong (Q) and exercise (E) groups on average at seven days per week. After intervention, the average number of days in the Q group was reported as 6.5 and in the E group, four. After six months, five and 3.5 for the Q and E groups, respectively, and after 12 months, five and four days. VAS before the treatments were, on average, 45 and 39 for the Q and E groups, respectively, right after treatment, 31 and 22, respectively, at six months, 26 and 23, respectively, and at 12 months, 28 and 21. Cervical range of motion, was measured at 123 at the start of the study in both groups, 140 after the intervention and at six months, in both groups, and 140 in the Q group, 150 in the E group at six months.

The authors write, "there were no differences in the effect of qigong and exercise therapy in patients with long term [neck pain]." The note that both groups of patients were compliant with the treatment programs. The authors concluded that the patients were able to reduce their pain and improve range of motion with both qigong and exercise, but it still is not known which is a better treatment option.

Birgitta Lansinger, MS, PT, et al. Qigong and Exercise Therapy in Patients with Long-term Neck Pain. In SPINE. October 2007. Vol. 32. No. 22. Pp. 2415-2422.

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