Neck Pain is Best Treated in a Combination Therapy Setting

Neck pain is commonly treated in chiropractic and physical therapy offices. People come in with acute and chronic neck pain, and variable histories. Acute pain is defined as pain that has developed recently. It could be from waking up wrong or having an object fall on your head. Chronic pain means a pain that reoccurs over time, especially over multiple years.

There have been numerous studiesshowing the benefits of both chiropractic and physical therapy care for neck pain. Massage therapy has been beneficial also in treatment of neck pain. There are fewer studies showing the differences between treatment types in a combination setting. Not many facilities offer the amount of treatment options that we do. Below is a summary article that compares combinations of treatments for neck pain.

I’ve always said the more tools in the toolbox, the more options available. If we only have a hammer we will treat everything like a nail. The study looked to compare the difference of chiropractic adjustments, physical therapy exercises, physical therapy stretching, electric modalities, coldlaser, massage, traction, and combination treatments.

As you see below there is a benefit to combination treatment. Different options provide greater results for both acute and chronic neck pain. Some treatments that work with acute pain are not as successful with chronic pain.

This is why in a treatment plan there are different treatment modalities for each phase of care. During the acute care phase there might be more interferential electric therapy to decrease pain and inflammation. As aperson progress, the electric modalities changes to a contraction type to decrease muscle spasms. Electric therapy shifts from decreasing pain to enhancing the exercises and stretches. Different types of electric therapy combined with traction, exercises,stretching, adjustments, and physical therapy treatments helpedgive the best option and care available.

Healing is a process with different phases. And it would be expected to see the different phases respond to different types of treatment. In atransition from acute and chronic care treatment modalities, frequency, and duration should change with treatment.

If you would like to review the article below please do so. Otherwise more information on neck pain treatment can be found on Massage Therapy or Graston Techniqe to enhance flexibility and decrease neck pain. Decompression therapy or traction therapy can also be found.

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Evidence-Based Guidelines for the Chiropractic Treatment of Adults With Neck Pain

Roland Bryans, DC, Philip Decina, DC, et al.

November 2013.


The purpose of this study was to develop evidence-based treatment recommendations for the treatment of nonspecific (mechanical) neck pain in adults.


Systematic literature searches of controlled clinical trialspublished through December 2011 relevant to chiropractic practice were conducted using the databases MEDLINE, EMBASE, EMCARE, Index to Chiropractic Literature, and the Cochrane Library. The number, quality, and consistency of findings were considered to assign an overall strength of evidence (strong, moderate, weak, or conflicting) and to formulate treatment recommendations.


Forty-one randomized controlled trials meeting the inclusion criteria and scoring a low risk of bias were used to develop 11 treatment recommendations. Strong recommendations were made for the treatment of chronic neck pain with manipulation, manual therapy, and exercise in combination with other modalities. Strong recommendations were also made for the treatmentof chronic neck pain with stretching, strengthening, and endurance exercises alone. Moderate recommendations were made for the treatment of acute neck pain with manipulation and mobilization in combination with other modalities. Moderate recommendations were made for the treatment of chronic neck pain with mobilization as well as massage in combination with other therapies. A weakrecommendation was made for the treatment of acute neck pain with exercise alone and the treatment of chronic neck pain with manipulation alone. Thoracic manipulation and trigger point therapy could not be recommended for the treatment of acute neck pain.Transcutaneous nerve stimulation, thoracic manipulation, laser,and traction could not be recommended for the treatment of chronic neck pain.


Interventions commonly used in chiropractic care improve outcomes for the treatment of acute and chronic neck pain. Increased benefit has been shown in several instances where a multimodal approach to neck pain has been used.

© 2013 National University of Health Sciences. Published by Elsevier Inc. All rights reserved. PubMed