Review of Treatments for Neck Pain

The study looked tocombine the information from numerous studies between 1980 and 2006. They tried to synthesize the data to give indications for the best types of treatment for neck pain. As with all scientific literature the information tends to build on itself. The collection of numerous studies helps providers make better treatment decisions. When numerous studies indicate the same result it is always a positive sign for providers to develop treatment plans with proper goals.

The study looked to identify types oftreatments for neck pain without radicular symptoms. This meansthat pain is localized to the neck region and does not radiate down past the shoulder. It once again found that combining different types of treatment focusing on functional improvements and activities is the best for achieving treatment goals. Treating pain for pain itself is not a great treatment strategy. Working to improve the limitations in the muscles, tendons, and joints toenhance the functional movement abilities will produce better treatment goals and outcomes.

Providers should be trying to look at range of motion and functional abilities. Functionally we want to look at what can you do, what cannot do, and what do you feel pain when doing. If you feel pain when reading for 30minutes, then we need to find ways to help improve your abilityto read for longer periods of time. During the course of treatment people find their ability to read with their head down improving from 30 minutes to 60 minutes. Eventually the time will increase to two hours before the onset of symptoms.

This isoften done by looking at what muscles are too tight, which are too relaxed, and which need strengthened. Treatment works to identify all the weak spots and get them to a desired and appropriate level. Many people have heard the phrase “the weakest link inthe chain is what breaks.” It does not matter how strong the rest of the links are because the weakest will always break first.With neck pain we see a similar concept. The weakest link in your functional chain will break first, and result in neck pain. Treatment can help identify the weak links and establish therapeutic goals to improve upon the weakest link.

A shotgun approach is never a great treatment strategy. Better results are usually produced when focusing on the limiting factors and weakest link.

The study abstract is listed below for your reading pleasure Massage Therapy or Graston Technique to enhance therapy. Pyramid theory is my personal example of how pain and injuries can be treated.

More information on therapeutic treatments utilizing PhysicalTherapy or Chiropractic can be directed to Google+.

Journal of Manipulative and Physiological Therapeutics

Volume 32, Issue 2, Supplement , Pages S141-S175, February 2009

Treatment of Neck Pain: Noninvasive Interventions

Eric L. Hurwitz, DC, PhD, Eugene J. Carragee, MD, FACS, Gabrielle van der Velde, DC, Linda J. Carroll, PhD, Margareta Nordin, PT, DrMedSc, Jaime Guzman, MD, MSc, FRCP(C), Paul M. Peloso, MD, MSc, FRCP(C), Lena W. Holm, DrMedSc, Pierre Côté, DC, PhD, SheilahHogg-Johnson, PhD, J. David Cassidy, DC, PhD, DrMedSc, Scott Haldeman, DC, MD, PhD


Study Design

Best evidence synthesis.


To identify, critically appraise, and synthesize literature from 1980through 2006 on noninvasive interventions for neck pain and itsassociated disorders.

Summary of Background Data

No comprehensive systematic literature reviews have been published on interventions for neck pain and its associated disordersin the past decade.


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 wereincluded in our best evidence synthesis.


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 thanno treatment, sham, or alternative interventions; however, noneof 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.


Our best evidence synthesis suggests that therapies involving manual therapy and exercise are more effective than alternative strategies for patients withneck 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 patientswith radicular symptoms and on the design and evaluation of neck pain prevention strategies.

© 2008 Lippincott Williams& Wilkins. Published by Elsevier Inc. All rights reserved. PubMed