Neck Pain Commentaries: Part 2
Our ongoing series of Editorials continues by reviewing what’s known about neck pain, and the success or failure of specific treatment approaches.
Today we will answer the question:
“Is Patient Advice Adequate for the Management of Neck Pain?”
The first article we will discuss is a Cochrane Database review [1] to assess whether patient education strategies, either alone or in combination with other treatments, are of benefit for pain, function, global perceived effect, quality of life, or patient satisfaction, in adults with neck pain with and without radiculopathy.
Researchers at McMaster University reviewed 10 high quality trials and found that “advice to activate, advice on stress coping skills, and neck schools” provided no additional benefits for patients suffering from acute or chronic neck pain, with or without radiculopathy. A more in-depth review of these studies was just published in the 8-26-2010 edition of Dynamic Chiropractic by the esteemed author Arthur Croft, DC, MS, MPH, FACO. [2]
Meanwhile, researchers at McMaster University reviewed 88 randomized clinical trials on neck pain, and concluded that “exercise combined with mobilization/manipulation, exercise alone, and intramuscular lidocaine for chronic mechanical neck disorders; intravenous glucocorticoid for acute whiplash associated disorders; and low-level laser therapy demonstrated either intermediate or longterm benefits.” [3]
That’s a far cry from Kaiser’s contention that cervical adjusting (manipulation) provides no benefit.
REFERENCES:
1. Patient education for neck pain with or without radiculopathy
Cochrane Database Syst Rev. 2009 (Jan 21); (1): CD005106
2. Is Advice Alone Adequate for the Management of Neck Pain?
Dynamic Chiropractic ~ August 26, 2010
3. Conservative management of mechanical neck disorders: a systematic review
J Rheumatol. 2007 (May); 34 (5): 1083-102. Epub 2007 Jan 15
Wow, now that is cool! ” . . .intermediate or longterm benefits.”
That’s what chiropractic does for neck pain.
The take-home message is that some of these basics (exercise and posture) that patients tend to ignore or overlook are probably the most important things for prevention of back and neck pain in the first place.