Neck pain is remarkably common with nearly half of us suffering at one time or another. Worst of all it keeps coming back. Many different types of treatment are currently used so which ones should you choose if you have neck pain? A recent review into the best ways to treat neck pain has just been published and it makes interesting reading.
Manipulation or mobilisation are good treatment options for neck pain especially when combined with laser therapy and advice, stretching and specific exercises. Massage can be helpful in combination with other forms of treatment but not on its own. This package of care is what our chiropractors and physio’s do here at Sundial.
The treatments that don’t have evidence of working for neck pain include TENS machines (is anyone still using these?); traction and trigger point therapy (a form of deep pressure on tender tight points in a muscle).
These findings are broadly similar to the Bone and Joint Decade (BJD) Task Force report on neck pain in 2008. In this report they go further by recommending acupuncture and pain killer medication. The list of treatments unlikely to help for neck pain are the same but go on to advise against surgery, collars, ultrasound, most types of injection into the neck and radio-frequency denervation.
The BJD report offers some helpful advice about choosing the right sort of treatment for a bad neck. Don’t expect to find a single “cause” for your neck pain. Stay as active as you can, reduce mental stress and try over-the- counter pain relievers first. If pain persists then seek treatment form a practitioner with the right sort of expertise. The authors conclude that no one treatment is likely to help everyone and you may need to mix and match approaches to find what works for you. Any treatment should show some improvement in your symptoms within two to four weeks. If not try something else. This advice also applies if you have mild whiplash from a road traffic collision for instance.
So what are the main points from these two reports? Two groups looking at neck pain independently have come up with very similar recommendations. These recommendations are also similar, as you might expect, for other spine related problems like back pain. Conservative treatment is best, you have to help too by doing the home exercises and keep going to find what works for you.
These messages are a big relief to the thousands of people who endure regular neck pain.
Evidence-based guidelines for the chiropractic treatment of adults with neck pain. Bryans R, Decina P, Descarreaux M, et al. Journal of Manipulative & Physiological Therapeutics 2014; 37: 42-63.
The Bone and Joint Decade 2000- 2010 Task Force on Neck Pain and Its Associated Disorders; Executive Summary, (2008), Haldeman S, Carroll L et al. Spine 33(4S):S5-S7