How to get rid of and alleviate neck pain.
"How to get rid of my neck pain?"
Common question - and one of the answers is chiropractic care intertwined with specific exercises. Let us have a look at the evidence behind this statement.
Practitioners of manual medicine, i.e. chiropractors, see patients presenting with short- and long term neck pain on almost a daily basis. There are a couple of different techniques which are utilized in treating these presentations, the most common being: high velocity-low amplitude manipulation, mobilization and instrument-assisted manipulation (activator). A study with 47 participants, conducted by Gemmell and Miller (2010) looked into the relative effectiveness and adverse effects of cervical manipulation, mobilization and the activator instrument in patients who were diagnosed with sub-acute neck pain of mechanical origin. The study, although it had a small sample size due to recruitment difficulties, showed positive results and concluded that:
…” it appears that all three methods of treating mechanical neck pain had a long-term benefit for subacute neck pain, without moderate or serious adverse events associated with any of the treatment methods.” …
In a recent large-scaled systematic review (Gross et al 2010) conducted by the Cochrane database, which thrones highest in the research hierarchy, 27 different studies (with a total of 1522 participants) looking into the effect of cervical manipulations were evaluated. The results showed that cervical manipulation may have good short-term effect in symptomatic relief after one to four treatment sessions. It further states that it may have a significant effect towards symptomatic relief for headache evaluated to have arisen from the anatomical structures of the neck (i.e. facet joint dysfunction), and that a higher amount of treatments are usually needed when headache accompanies the neck pain:
… “nine or 12 sessions were superior to three for pain and disability in cervicogenic headache.” …
The study further stated that adding thoracic manipulation as an additional therapy gives significant effect in terms of reducing pain and improving function in patients with acute neck pain, although the evidence for this was rated ‘low’ and not ‘moderate’ like the previous statement.
Another Cochrane database systematic review, published in 2005 (Kay et al 2005), stated that:
… “There is strong evidence of benefit favouring a multimodal care approach of exercise combined with mobilisation or manipulation for subacute and chronic MND (mechanical neck disorders) with or without headache, in the short and long term. ” …
Thus, emphasizing the importance of the patient receiving a stretching and strengthening exercise program which should concentrate on the musculature of the cervical, shoulder-thoracic area, as this will give additional benefit for the patient, especially in the long-term, with reduced chance of reoccurring neck pain and improved function. Ask your chiropractor for a training program which you can do at home or at another training facility, he/she will be happy to help you. If you do not have the time to wait and really want to train that neck, you can have a look at my neck exercises article which deals with the essentials you need to know.
If you have any questions or comments, please submit them below.
Gemmell H, Miller P. Relative effectiveness and adverse effects of cervical manipulation, mobilisation and the activator instrument in patients with sub-acute non-specific neck pain: results from a stopped randomised trial. Chiropr Osteopat. 2010 Jul 9;18:20. http://www.ncbi.nlm.nih.gov/pubmed/20618936
Gross A, Miller J, D'Sylva J, Burnie SJ, Goldsmith CH, Graham N, Haines T, Brønfort G, Hoving JL. Manipulation or mobilisation for neck pain. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD004249. http://www.ncbi.nlm.nih.gov/pubmed/20091561
Kay TM, Gross A, Goldsmith C, Santaguida PL, Hoving J, Bronfort G; Cervical Overview Group. Exercises for mechanical neck disorders. Cochrane Database Syst Rev. 2005 Jul 20;(3):CD004250. http://www.ncbi.nlm.nih.gov/pubmed/16034925
Muscular weakness is a common cause of neck pain.
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