Abstract
Study Design
Best evidence synthesis.
Objective
To identify, critically appraise, and synthesize literature from 1980 through 2006
on noninvasive interventions for neck pain and its associated disorders.
Summary of Background Data
No comprehensive systematic literature reviews have been published on interventions
for neck pain and its associated disorders in the past decade.
Methods
We systematically searched Medline and screened for relevance literature published
from 1980 through 2006 on the use, effectiveness, and safety of noninvasive interventions
for neck pain and associated disorders. Consensus decisions were made about the scientific
merit of each article; those judged to have adequate internal validity were included
in our best evidence synthesis.
Results
Of the 359 invasive and noninvasive intervention articles deemed relevant, 170 (47%)
were accepted as scientifically admissible, and 139 of these related to noninvasive
interventions (including health care utilization, costs, and safety). For whiplash-associated
disorders, there is evidence that educational videos, mobilization, and exercises
appear more beneficial than usual care or physical modalities. For other neck pain,
the evidence suggests that manual and supervised exercise interventions, low-level
laser therapy, and perhaps acupuncture are more effective than no treatment, sham,
or alternative interventions; however, none of the active treatments was clearly superior
to any other in either the short- or long-term. For both whiplash-associated disorders
and other neck pain without radicular symptoms, interventions that focused on regaining
function as soon as possible are relatively more effective than interventions that
do not have such a focus.
Conclusion
Our best evidence synthesis suggests that therapies involving manual therapy and exercise
are more effective than alternative strategies for patients with neck pain; this was
also true of therapies which include educational interventions addressing self-efficacy.
Future efforts should focus on the study of noninvasive interventions for patients
with radicular symptoms and on the design and evaluation of neck pain prevention strategies.
Key words
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Article info
Footnotes
The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.
Corporate/Industry, Foundation, and Professional Organizational funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.
Reprinted from Hurwitz EL et al. Treatment of neck pain: noninvasive interventions. Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Spine 2008;33:S123-S152. Reprinted with permission from Lippincott Williams & Wilkins
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© 2008 Lippincott Williams & Wilkins. Published by Elsevier Inc. All rights reserved.
