Conservative Care Options for Neck Pain
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Conservative Care Options for Neck Pain
Physicians, now more than ever are recommending conservative treatment including manual therapy, acupuncture, education and exercise as part of a multi-modal approach for patients suffering from neck pain (Busse et al. 2017, Kjaer et al. 2017)
Types of Neck Pain
Proper assessment help identify who is most likely to benefit from conservative treatments. Recent clinical guidelines published in the JOSPT suggest that patients with neck pain fall into 1 of 4 groups (Blandpied et al. 2017):
• neck pain with limited motion
• neck pain associated with whiplash
• headaches related to neck pain
• neck and nerve-related pain into the arm (also known as radicular pain).
Conservative Care Options for Neck Pain
Massage Therapy and Neck Pain - For those who suffer from neck pain, massage therapy has been shown to be a safe, effective non-pharmacological therapeutic intervention that is simple to carry out, economical, and has very few side effects (Brosseau et al. 2012, Bussières et al. 2016, Côté et al. 2016, Nahin et al. 2016, Sutton et al. 2016, Wong et al. 2016, van der Velde et al. 2016).
Acupuncture and Neck Pain - There is quite a bit of research suggesting that acupuncture/electro-acupuncture has therapeutic benefit for neck pain (Blanpied et al. 2017, Cerezo-Téllez et al. 2016, Gerber et al. 2017, Kjaer et al. 2017).
Talk to your local physicians about conservative treatment options
Massage therapists are uniquely suited to incorporate a number management strategies (exercise, education, acupuncture and manual therapy) to help decrease neck pain and increase function. Proper assessment and referrals are important to identify who is most likely to benefit from conservative treatments.
More to Explore- clinical research related to neck pain.
Blanpied, P.R., Gross, A.R., Elliott, J.M., Devaney, L.L., Clewley, D., Walton, D.M., Sparks, C., Robertson, E.K. (2017). Neck Pain: Revision 2017. J Orthop Sports Phys Ther
https://www.ncbi.nlm.nih.gov/pubmed/28666405
Brosseau, L., Wells, G.A., Tugwell, P., Casimiro, L., Novikov, M., ... Cohoon C. (2012). Ottawa Panel evidence-based clinical practice guidelineon therapeutic massage for neck pain. J Bodyw Mov Ther.
https://www.ncbi.nlm.nih.gov/pubmed/22703740
Busse, J.W., Craigie, S., Juurlink, D.N, ... Guyatt GH. (2017). Guideline for opioid therapy and chronic noncancer pain. CMAJ.
https://www.ncbi.nlm.nih.gov/pubmed/28483845
Bussières, A. E., Stewart, G., Al-Zoubi, F., Decina, P., Descarreaux, M., Hayden, J., . . . Ornelas, J. (2016). The Treatment of Neck Pain–Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline. Journal of Manipulative and Physiological Therapeutics.
https://www.ncbi.nlm.nih.gov/pubmed/27836071
Cerezo-Téllez, E., Torres-Lacomba, M.,... Gutiérrez-Ortega, C. (2016). Prevalence of Myofascial Pain Syndrome in Chronic Non-Specific Neck Pain: A Population-Based Cross-Sectional Descriptive Study. Pain Med.
https://www.ncbi.nlm.nih.gov/pubmed/27330152
Cerezo-Téllez, E., Torres-Lacomba, M., Fuentes-Gallardo, I., Perez-Muñoz, M., Mayoral-Del-Moral, O., Lluch-Girbés, E., . . . Falla, D. (2016). Effectiveness of dry needling for chronic nonspecific neck pain. Pain.
http://www.ncbi.nlm.nih.gov/pubmed/27537209
Cerezo-Téllez, E., Lacomba, M. T., Fuentes-Gallardo, I., Moral, O. M., Rodrigo-Medina, B., & Ortega, C. G. (2016). Dry needling of the trapezius muscle in office workers with neck pain: A randomized clinical trial. Journal of Manual & Manipulative Therapy.
https://www.ncbi.nlm.nih.gov/pubmed/27582622
Chen, L., Michalsen, A. (2017). Management of chronic pain using complementary and integrative medicine. BMJ.
https://www.ncbi.nlm.nih.gov/pubmed/28438745
Childress, M.A., Becker, B.A. (2016). Nonoperative Management of Cervical Radiculopathy. Am Fam Physician.
https://www.ncbi.nlm.nih.gov/pubmed/27175952/
Cho, J., Nam, D., Kim, K., & Lee, J. (2013). Acupuncture with non-steroidal anti-inflammatory drugs (NSAIDs) versus acupuncture or NSAIDs alone for the treatment of chronic neck pain: An assessor-blinded randomised controlled pilot study. Acupuncture in Medicine.
https://www.ncbi.nlm.nih.gov/pubmed/24171895
Cohen, S.P., Hooten, W.M. (2017). Advances in the diagnosis and management of neck pain. BMJ.
https://www.ncbi.nlm.nih.gov/pubmed/28807894
Cook, A. J., Wellman, R. D., Cherkin, D. C., Kahn, J. R., & Sherman, K. J. (2015). Randomized clinical trial assessing whether additional massage treatments for chronic neck pain improve 12- and 26-week outcomes. The Spine Journal.
https://www.ncbi.nlm.nih.gov/pubmed/26096474
Costello, M., Puentedura, E. ‘, Cleland, J., & Ciccone, C. D. (2016). The immediate effects of soft tissue mobilization versus therapeutic ultrasound for patients with neck and arm pain with evidence of neural mechanosensitivity: A randomized clinical trial. Journal of Manual & Manipulative Therapy.
https://www.ncbi.nlm.nih.gov/pubmed/27559283
De Meulemeester, K.E., Castelein, B., Coppieters, I., Barbe, T., Cools, A., Cagnie, B. (2017). Comparing Trigger Point Dry Needling and Manual Pressure Technique for the Management of Myofascial Neck/Shoulder Pain: A Randomized Clinical Trial. J Manipulative Physiol Ther.
https://www.ncbi.nlm.nih.gov/pubmed/28017188
Dewitte, V., Peersman, W., ... Cagnie, B. (2016). Subjective and clinical assessment criteria suggestive for five clinical patterns discernible in nonspecific neck pain patients. A Delphi-survey of clinical experts. Man Ther.
https://www.ncbi.nlm.nih.gov/pubmed/27507590
Gerber, L. H., Sikdar, S., Aredo, J. V., Armstrong, K., Rosenberger, W. F., Shao, H., & Shah, J. P. (2017). Beneficial Effects of Dry Needling for Treatment of Chronic Myofascial Pain Persist for 6 Weeks After Treatment Completion. Pm&r.
http://www.ncbi.nlm.nih.gov/pubmed/27297448
Gerber, L. H., Shah, J., Rosenberger, W., Armstrong, K., Turo, D., Otto, P., . . . Sikdar, S. (2015). Dry Needling Alters Trigger Points in the Upper Trapezius Muscle and Reduces Pain in Subjects With Chronic Myofascial Pain. Pm&r
https://www.ncbi.nlm.nih.gov/pubmed/25661462
Gross, A., Langevin, P., Burnie, S. J., Bédard-Brochu, M., Empey, B., Dugas, E., . . . Leblanc, F. (2015). Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Database of Systematic Reviews.
https://www.ncbi.nlm.nih.gov/pubmed/26397370
Haller, H., Lauche, R., Cramer, H., Rampp, T., Saha, F. J., Ostermann, T., & Dobos, G. (2016). Craniosacral Therapy for the Treatment of Chronic Neck Pain. The Clinical Journal of Pain.
https://www.ncbi.nlm.nih.gov/pubmed/26340656 (OPEN ACCESS)
Kjaer, P., Kongsted, A., Hartvigsen, J., ... Povlsen, T.M. (2017). National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy. Eur Spine J.
https://www.ncbi.nlm.nih.gov/pubmed/28523381
Macpherson, H., Tilbrook, H., Richmond, S., Woodman, J., Ballard, K., Atkin, K., . . . Watt, I. (2015). Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain. Annals of Internal Medicine.
https://www.ncbi.nlm.nih.gov/pubmed/26524571
MacPherson, H., Vickers, A., Bland, M., Torgerson, D., Corbett, M., Spackman, E., ..., Watt, I. (2017). Acupuncture for chronic pain and depression in primary care: a programme of research. Southampton (UK): NIHR Journals Library.
https://www.ncbi.nlm.nih.gov/pubmed/28121095
Morikawa, Y., Takamoto, K., Nishimaru, H., Taguchi, T., Urakawa, S., Sakai, S., Ono, T., Nishijo, H. (2017). Compression at Myofascial Trigger Point on Chronic Neck Pain Provides Pain Relief through the Prefrontal Cortex and Autonomic Nervous System: A Pilot Study. Front Neurosci.
https://www.ncbi.nlm.nih.gov/pubmed/28442987 (OPEN ACCESS)
Nahin, R. L., Boineau, R., Khalsa, P. S., Stussman, B. J., & Weber, W. J. (2016). Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States. Mayo Clinic Proceedings.
https://www.ncbi.nlm.nih.gov/pubmed/27594189
Nee, R.J., Vicenzino, B., Jull, G.A., Cleland, J.A., & Coppieters, M.W. (2012). Neural tissue management provides immediate clinically relevant benefits without harmful effects for patients with nerve-related neck and arm pain: a randomised trial. Journal of Physiotherapy.
https://www.ncbi.nlm.nih.gov/pubmed/22341379
Pecos-Martín, D., Montañez-Aguilera, F. J., Gallego-Izquierdo, T., Urraca-Gesto, A., Gómez-Conesa, A., Romero-Franco, N., & Plaza-Manzano, G. (2015). Effectiveness of Dry Needling on the Lower Trapezius in Patients With Mechanical Neck Pain: A Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation.
https://www.ncbi.nlm.nih.gov/pubmed/25582412
Rodríguez-Huguet, M., Gil-Salú, J.L., ... Lomas-Vega, R. (2017). Effects of Myofascial Release on Pressure Pain Thresholds in Patients With Neck Pain: A Single-Blind Randomized Controlled Trial. Am J Phys Med Rehabil.
https://www.ncbi.nlm.nih.gov/pubmed/28678033
Sherman, K. J., Cook, A. J., Wellman, R. D., Hawkes, R. J., Kahn, J. R., Deyo, R. A., & Cherkin, D. C. (2014). Five-Week Outcomes From a Dosing Trial of Therapeutic Massage for Chronic Neck Pain. The Annals of Family Medicine.
https://www.ncbi.nlm.nih.gov/pubmed/24615306
Sherman, K. J., Cherkin, D. C., Hawkes, R. J., Miglioretti, D. L., & Deyo, R. A. (2009). Randomized Trial of Therapeutic Massage for Chronic Neck Pain. The Clinical Journal of Pain.
https://www.ncbi.nlm.nih.gov/pubmed/19333174
Sutton, D. A., Côté, P., Wong, J. J., Varatharajan, S., Randhawa, K. A., Yu, H., . . . Stupar, M. (2016). Is multimodal care effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. The Spine Journal.
https://www.ncbi.nlm.nih.gov/pubmed/25014556
van der Velde, G., Yu, H., Paulden, M., Côté, P., Varatharajan, S., Shearer, H.M., Wong, J.J.,...,Taylor-Vaisey, A. (2016). Which interventions are cost-effective for the management of whiplash-associated and neck pain-associated disorders? A systematic review of the health economic literature by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. The Spine Journal.
https://www.ncbi.nlm.nih.gov/pubmed/26631759
Wong, J. J., Shearer, H. M., Mior, S., Jacobs, C., Côté, P., Randhawa, K., . . . Taylor-Vaisey, A. (2016). Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? an update of the bone and joint decade task force on neck pain and its associated disorders by the optima collaboration. The Spine Journal.
https://www.ncbi.nlm.nih.gov/pubmed/26707074