Spine Task Force Neck Pain Evidence Summary Table 2

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

FROM:   Journal of J Manipulative Physiol Ther 2009 (Feb); 32 (2): S141–S175
Treatment of Neck Pain: Noninvasive Interventions:
Results of the Bone and Joint Decade 2000–2010 Task Force
on Neck Pain and Its Associated Disorders

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Table 2: Non-invasive neck pain treatment

Grade of neck pain and scenario	Likely helpful	Possibly helpful	Likely not helpful	Not enough evidence *
Grade I and II (acute) traumatic neck pain	Educational video, mobilization, exercises, mobilization plus exercises	Pulsed electromagnetic therapy	Pamphlet/neck booklet alone, passive modalities (heat, cold, diathermy, hydrotherapy), referral to fitness or rehab program, frequent early health-care service, methylprednisolone, passive modalities (ultrasound, TENS), exercise instruction, botulinum toxin A	Manipulation, traction, non-steroidal anti-inflammatory drugs (NSAIDS), other drugs
Grade I and II (non-acute) traumatic neck pain		Supervised exercises, coordinated multidisciplinary care	Passive modalities (TENS, ultrasound), corticosteroid injections	Manipulation, traction, NSAIDs, other drugs
Grade I and II non-traumatic neck pain	Manipulation, mobilization, supervised exercises, manual therapy (manipulation, mobilization, massage) plus exercises, acupuncture, low-level laser therapy, analgesics	Percutaneous neuromuscular therapy, brief intervention using cognitive behavioural principles	Advice alone, collars, passive modalities (heat therapy, ultrasound, TENS, electrical muscle stimulation), exercise instruction, botulinum toxin A	Magnetic stimulation, massage alone, traction, NSAIDS, other drugs
Grade III (suspected cervical radiculopathy)				All interventions
Non-invasive neck pain treatment (other conditions) Note: The following scenarios are presented separately as they were not classified in the grade system.
Grade of neck pain and scenario	Likely helpful	Possibly helpful	Likely not helpful	Not enough evidence *
Cervicogenic headache		Manipulation, mobilization, supervised exercises, manipulation or mobilization plus supervised exercises, water pillow		Passive modalities, traction, NSAIDS, other drugs
Neck pain in workers		Supervised exercises plus strength or endurance training and/or relaxation training with behavioral support	Ergonomic interventions, forced work breaks, rehabilitation programs, stress management programs, relaxation training, physical training, exercise instruction

*More research is needed to understand the impact of these treatments and greater clinical judgment should be used if considering these options.



Since 6-19-2010