Neck Pain Tool-kit: Step 4
This page is part of the 'Manual Therapy & Exercise for Neck Pain: Clinical Treatment Tool-kit' resource for clinical decision making, which provides evidence, techniques, and dosages for the use of manual therapy and exercise in the treatment of neck pain. Please see the main project page for further information, or to return to Step 1 to identify your patient. Otherwise, proceed to Step 4 below to consider dosage.
- The dosage corresponding to the techniques selected in step 3 is presented below, organized by patient characteristics
4.1 Neck pain alone
4.2 Neck pain with cervicogenic headache
4.3 Whiplash associated disorder
4.4 Neck pain with radiculopathy
- Once you have found the evidence most applicable to your patient, click on ‘Step 5- Individualize your treatment’ for other considerations in applying the evidence to your patient
2.1 Neck pain alone (non-specific)[edit | edit source]
Acute/subacute neck pain[edit | edit source]
Thoracic manipulation[edit | edit source]
Cleland 2007[edit | edit source]
Disorder Type | Acute/subacute neck pain |
---|---|
Treatment (T) / Comparison (C) | T: Thoracic distraction manipulation + adjunct exercise C: Prone thoracic mobilization + adjunct exercise |
Frequency | 1 session |
Dose | 1-2 manipulations |
Duration | 1 session |
Follow-up | 0 |
- Click to return to Step 3: Inform your technique Cleland 2007
Gonzalez-Iglesias 2009
[edit | edit source]
Disorder Type | Acute neck pain |
---|---|
Treatment (T) / Comparison (C) | T: Seated thoracic distraction manipulation + adjunct treatment C: Adjunct treatment - electrothermal therapy (infrared therapy + TENS) |
Frequency | 1 session/week of manipulation, 5 sessions over 3 weeks of ETT |
Dose | 1-2 manipulations |
Duration | 3 weeks, 5 sessions |
Follow-up | 04 weeks |
ETT: Electrothermal therapy.
Subacute/chronic neck pain[edit | edit source]
Manual therapy and exercise[edit | edit source]
Study Year/Disorder Type | Treatment (T) / Comparison (C) | Frequency | Dose | Duration | Follow-up |
---|---|---|---|---|---|
Bronfort 2001[1] Chronic neck pain |
T: Spinal manipulation and massage to the cervical and thoracic spine and exercise therapy
C:
|
20 sessions over 11 weeks | 15 minutes of manipulation and massage 45 minutes of exercise therapy Dumbbell shoulder exercises: 2 x 15-30 repetitions with 2-10lbs Pulley exercises: 1.25-10 lbs resistance |
11 weeks, 20 sessions |
52 and 104 weeks |
Hoving 2002[2] Neck pain of mixed duration with or without cervicogenic headache or radiculopathy |
T: Muscular and articular mobilization techniques to the cervical spine, coordination and stabilization techniques
C:
|
1 session/week | 45 minute treatment sessions, exercise and manual therapy dosage not reported | Max. 6 weeks, 3-6 sessions |
52 weeks |
Jull 2002[3] Chronic neck pain with cervicogenic headache |
T: Manipulation or mobilization and low load endurance exercise for cervicoscapular region
C:
|
1-2 sessions/week | Treatment sessions: up to 30 minutes long Deep neck flexor exercises: twice/day Postural correction exercises: regularly throughout the day |
6 weeks, 8-12 sessions |
52 weeks |
Skargren 1998[4] Chronic neck pain |
T : Physiotherapy (PT): technique: 1% manipulation, 25% mobilization, 15% traction, 25% soft tissue treatment, 33% McKenzie treatment, 21% individual training, 15% transcutaneous electrical nerve stimulation/ ultrasound/ cold, 15% individual program, 6% relaxation training, 4% acupuncture, 1% instruction on individual training;
C: Chiropractic (chiro): technique: 97% manipulation, 11% mobilization, 2% traction, 2% soft tissue treatment, 1% individual training, frequency: mean 5.6 sessions over mean 4.9 weeks; dose: NR; route: cervical spine |
Mean 7.5 sessions over 6.4 weeks | Not reported | 5-6 weeks, 6-8 sessions |
52 weeks |
Ylinen 2003 [5] Chronic neck pain |
T:
C: Control (aerobics and stretching) |
Exercises: 5 sessions/week for 2 weeks; 3 times/week for 1 year at home Physical therapy: |
45 minute exercise sessions
|
2 weeks, 10 sessions |
12 months |
Allison 2002[6] Neck pain with mechanically sensitive neural tissue |
T:
C: Wait-list control |
Not reported | Active movements at home performed 10 repetitions, 1-3 times/day | 8 weeks | 0 |
Brodin 1982[7] Chronic neck pain with or without radicular findings |
T: Passive mobilizations, massage, manual traction, heat, analgesics, education
C:
|
3 sessions/week | Not reported | 9 sessions, 3 weeks |
1 week |
Karlberg 1996[8] Subacute neck pain with dizziness |
T: Cervical mobilization, soft tissue treatment, stabilization exercise, relaxation techniques, non-steroidal anti-inflammatory, education
C: Delayed Treatment Group |
Median 13 sessions over median 13 weeks | Not reported | 5-23 sessions, 5-20 weeks | 0 |
Palmgren 2006[9] Chronic neck pain |
T: Education, cervical manipulation, myofascial technique, exercise (spine stabilizing for cervical region and cervicothoracic junction) | 3-5 sessions over 5 weeks | Not reported | 3-5 sessions, 5 weeks |
0 |
Manual therapy[edit | edit source]
Exercise[edit | edit source]
Unspecified/mixed duration neck pain[edit | edit source]
Exercise[edit | edit source]
Manual therapy[edit | edit source]
2.2 Neck pain with cervicogenic headache[edit | edit source]
Acute/subacute neck pain with cervicogenic headache[edit | edit source]
Manual therapy and exercise[edit | edit source]
Exercise[edit | edit source]
Manual therapy[edit | edit source]
Chronic neck pain with cervicogenic headache[edit | edit source]
Manual therapy and exercise[edit | edit source]
Exercise[edit | edit source]
Manual therapy[edit | edit source]
2.3 Whiplash associated disorder[edit | edit source]
Acute/subacute whiplash associated disorder[edit | edit source]
Manual therapy and exercise[edit | edit source]
Exercise[edit | edit source]
Manual therapy[edit | edit source]
Chronic whiplash associated disorder[edit | edit source]
Manual therapy and exercise
[edit | edit source]
2.4 Neck pain with radiculopathy[edit | edit source]
Acute neck pain with radiculopathy
[edit | edit source]
Exercise[edit | edit source]
Manual therapy
[edit | edit source]
References[edit | edit source]
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