The Treatment of Neck Pain–Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline
Written by Editor   
Tuesday, December 06, 2016 12:00 AM

News Bite: A new clinical guideline for neck pain that replaces two prior guidelines is summarized. 

 


A multimodal approach including manual therapy, self-management advice, and exercise is an effective treatment strategy for both recent-onset and persistent neck pain.  This study sought to develop a clinical practice guideline on the management of neck pain–associated disorders (NADs) and whiplash-associated disorders (WADs). The resulting guideline replaces two prior chiropractic guidelines on NADs and WADs.

For recent-onset (0-3 months) neck pain, we suggest offering multimodal care; manipulation or mobilization; range-of-motion home exercise, or multimodal manual therapy (for grades I-II NAD); supervised graded strengthening exercise (grade III NAD); and multimodal care (grade III WAD). 

For persistent (>3 months) neck pain, we suggest offering multimodal care or stress self-management; manipulation with soft tissue therapy; high-dose massage; supervised group exercise; supervised yoga; supervised strengthening exercises or home exercises (grades I-II NAD); multimodal care or practitioner’s advice (grades I-III NAD); and supervised exercise with advice or advice alone (grades I-II WAD). 

For workers with persistent neck and shoulder pain, evidence supports mixed supervised and unsupervised high-intensity strength training or advice alone (grades I-III NAD).

Pertinent systematic reviews on 6 topic areas (education, multimodal care, exercise, work disability, manual therapy, passive modalities) were assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR) and data extracted from admissible randomized controlled trials. The guideline was peer reviewed by a 10-member multidisciplinary (medical and chiropractic) external committee.


Source: http://www.jmptonline.org/article/S0161-4754(16)30192-0/fulltext?elsca1=etoc&elsca2=email&elsca3=0161-4754_201610_39_8_&elsca4=Physical%20Medicine%20and%20Rehabilitation%7CHealth%20Professions