Neck Disorder Guidelines

This section was compiled by Frank M. Painter, D.C.
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Best-Practice Recommendations for Chiropractic Management
of Patients With Neck Pain

J Manipulative Physiol Ther. 2019 (Nov); 42 (9): 635–650 ~ FULL TEXT

A set of best-practice recommendations for chiropractic management of patients with neck pain based on the best available evidence reached a high level of consensus by a large group of experienced chiropractors. The recommendations indicate that manipulation and mobilization as part of a multimodal approach are front-line approaches to patients with uncomplicated neck pain.

National Clinical Guidelines for Non-surgical Treatment of
Patients with Recent Onset Neck Pain or Cervical Radiculopathy

European Spine Journal 2017 (Sep); 26 (9): 2242–2257 ~ FULL TEXT

Two multidisciplinary working groups were commissioned by DHA to developed new Danish National Clinical Guidelines for non-surgical treatment in patients with recent onset of NP and CR. The recommendations are generally based on weak evidence or on consensus. However, they are well aligned with recommendations from similar guidelines from North America. The guideline working groups strongly recommend to intensify research efforts in relation to all aspects of the management of NP and CR.

The Treatment of Neck Pain-Associated Disorders and
Whiplash-Associated Disorders:
A Clinical Practice Guideline

J Manipulative Physiol Ther. 2016 (Oct); 39 (8): 523–564 ~ FULL TEXT

The objective was to develop a clinical practice guideline on the management of neck pain-associated disorders (NADs) and whiplash-associated disorders (WADs).
This guideline replaces 2 prior chiropractic guidelines on NADs and WADs

Management of Neck Pain and Associated Disorders:
A Clinical Practice Guideline from the Ontario
Protocol for Traffic Injury Management (OPTIMa) Collaboration

European Spine Journal 2016 (Jul); 25 (7): 2000–2022 ~ FULL TEXT

This guideline is based on recent systematic reviews of high-quality studies. A multidisciplinary expert panel considered the evidence of effectiveness, safety, cost-effectiveness, societal and ethical values, and patient experiences (obtained from qualitative research) when formulating recommendations. Target audience includes clinicians; target population is adults with grades I-III NAD <6 months duration.

Whiplash-associated Disorders
From the Canadian Chiropractic Guideline Initiative (CCGI)
Practitioner guide and algorithm:
Full guideline:

Previous guidelines:

Neck Disorders (not due to whiplash)
From the Canadian Chiropractic Guideline Initiative (CCGI)

Practitioner guide and algorithm:

Full guideline:
Previous guidelines:

Neck Pain Evidence Summary: The Bone and Joint Decade
Task Force on Neck Pain
Institute for Work & Health 2010 (25 pages PDF file) ~ FULL TEXT

Neck pain is common among workers, and has many different causes. While neck pain can't always be cured, there are a variety of treatments. It can include the chronic pain of workers whose jobs can strain their necks, such as lifting done by nurses’ aides and construction workers. It results from accidents, such as whiplash in drivers who’ve been rear-ended. Neck pain also includes tension headaches in anyone who has had a tough day at work. Psychological and social factors also play a role in the onset and course of neck pain. The Neck Pain Task Force created a conceptual model of neck pain which is described in the summary to capture the onset, course and care of neck pain determined by the group.

Practice Guide for the Management of
Whiplash-Associated Disorders in Adults
Canadian Chiropractic Association 2010 (18 pages PDF file) ~ FULL TEXT

This material was developed by the Guideline Development Committee (GDC) under the auspices of The Canadian Chiropractic Association and the Canadian Federation of Chiropractic Regulatory and Education Accrediting Boards, Clinical Practice Guidelines Development Initiative (The CCA•CFCREAB-CPG).

Treatment of Neck Pain: Noninvasive Interventions:
Results of the Bone and Joint Decade 2000–2010
Task Force on Neck Pain and Its Associated Disorders

J Manipulative Physiol Ther. 2009 (Feb); 32 (2 Suppl): S141–S175 ~ FULL TEXT

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.

Chiropractic Clinical Practice Guideline: Evidence-based
Treatment of Adult Neck Pain Not Due to Whiplash

J Canadian Chiro Assoc 2005 (Sep); 49 (3): 158–209 ~ FULL TEXT

Researchers worked with the Canadian Chiropractic Association, the Canadian Federation of Chiropractic Regulatory Boards, the Clinical Practice Guidelines Development Initiative, and the Guidelines Development Committee (GDC) to provide an evidence-based clinical practice guideline for the chiropractic cervical treatment of adults with acute or chronic neck pain not due to whiplash.

Dr. Arthur C. Croft's Recommendations for Care
This set of 6 tables from the book Whiplash Injuries: The Cervical Acceleration/ Deceleration Syndrome (Third Edition) contains complicating factors for recovery, guidelines for frequency and duration of care, treatment adjuncts and contraindications to manipulation.

Evaluation of Neck Injuries (1997)
From the California Department of Industrial Relations website.

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