Neck Pain Tool-kit: Step 2

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 2 below to determine the evidence.

• The evidence regarding the use of manual therapy and exercise for the treatment of neck pain is presented below, organized by patient characteristics
  

• Once you have found the evidence most applicable to your patient, click on ‘Step 3-inform your technique’ to see the techniques utilized in the positive studies for that patient population

2.1 Neck pain alone (non-specific)

Acute/subacute neck pain

Manual therapy

Author, year of original studies	Participant characteristics	Intervention	Comparison	Pain	Function/ Disability	GPE	Patient Satisfaction	QoL
Cleland 2007	Acute/subacute neck pain	Thoracic manipulation + adjunct treatment	Thoracic mobilization + adjunct exercise	▲▲	▲▲	▲▲
Gonzalez-Iglesias 2009	Acute neck pain	Thoracic manipulation + adjunct treatment	Adjunct electrothermal therapy	▲, ▲▲	▲, ▲▲
Egwu 2008	Acute/subacute neck pain	Ipsilateral PA or AP mobilization	Rotation or transverse mobilization	∆

AP: Anterior-posterior; GPE: Global perceived effect; QoL: Quality of life; PA: Posterior-anterior.

• Now go back to Step 1: Identify your patient, or continue to Step 3: Inform your technique.

Subacute/chronic neck pain

Manual Therapy and Exercise

Author, year of original studies	Participant characteristics	Intervention	Comparison	Pain	Function/ Disability	GPE	Patient Satisfaction	QoL
Bronfort 2001, Hoving 2002, Jull 2002	Subacute/chronic neck pain with or without CGH	Manipulation or mobilization and exercise	Primarily exercise alone	♦♦, ◊◊◊◊	◊◊, ◊◊◊◊	◊◊, ◊◊◊◊		◊◊, ◊◊◊◊
Bronfort 2001, Skargren 1998	Chronic neck pain	Manipulation or mobilization and exercise	Primarily manipulation or mobilization alone	●●●●				●●●●
Ylinen 2003	Chronic neck pain	Manipulation, mobilization, and exercise	Adjunct advice including general exercise	●●●●	●●●●
Allison 2002, Brodin 1985, Jull 2002, Karlberg 1996	Subacute/chronic neck pain with or without CGH or Radiculopathy	Manipulation or mobilization and exercise	No treatment	▲, ▲▲, ▲▲▲▲
Palmgren 2006	Chronic neck pain	Manipulation or mobilization and exercise	Advice	▲
Hoving 2002, Walker 2008	Chronic or mixed duration neck pain	Manipulation or mobilization and exercise	Traditional care	○○○○
Persson 2001	Chronic neck pain with radicular symptoms	Manipulation or mobilization and exercise	Collar therapy or surgery	∆
Vasseljen 1995	Chronic neck pain	Manipulation or mobilization and exercise	Exercise	∆∆∆

AP: Anterior-posterior; CGH: Cervicogenic headache; GPE: Global perceived effect; QoL: Quality of life; PA: Posterior-anterior.

• Now go back to Step 1: Identify your patient, or continue to Step 3: Inform your technique.

Exercise

Von Trott 2009, Rendent 2011

Author, year of original studies	Participant characteristics	Intervention	Comparison	Pain	Function/ Disability	GPE	Patient Satisfaction	QoL
Chiu 2005, Evans 2002, Franca 2008, Martel 2011	Chronic neck pain	Combined cervical and scapulothoracic stretching and strengthening + adjunct treatment	Adjunct treatment (varied)	♦, ●●, ♦♦♦, ○○○○	♦, ●●, ♦♦♦, ●●●●	●, ○○, ○○○, ○○○○	●, ●●, ●●●, ●●●●	○, ○○, ○○○, ○○○○
Von Trott 2009, Rendent 2011	Chronic neck pain	Qigong exercises (Dantian Qigong)	Wait list control	●, ●●	●, ●●	○, ○○		●, ●●
Von Trott 2009, Rendent 2011	Chronic neck pain	Cervical range of motion and strengthening exercise	Wait list control	▲, ▲▲	▲, ▲▲	∆, ∆∆		∆, ∆∆
Helewa 2007	Chronic neck pain	Isometric neck exercises + adjunct treatment	Adjunct pillow	▲, ▲▲	▲, ▲▲			▲, ▲▲
Goldie 1970, Helewa 2007	Chronic neck pain	Isometric neck exercises	No treatment	∆, ∆∆	∆, ∆∆	▲		∆, ∆∆
Revel 1994	Chronic neck pain	Eye neck coordination exercises + adjunct treatment	Adjunct medication	▲▲	▲▲
Viljanen 2006	Chronic neck pain with/without whiplash associated disorder (WAD)	Upper extremity stretching and endurance training	Normal activities	○, ○○, ○○○○	○, ○○, ○○○○
Kjellman 2002	Chronic neck pain	Neck and upper extremity stretch and strengthening program	Sham ultrasound	∆, ∆∆, ∆∆∆, ∆∆∆∆	∆, ∆∆, ∆∆∆, ∆∆∆∆
Kjellman 2002	Chronic neck pain	Cervical movement exercises (McKenzie)	Sham ultrasound	∆, ∆∆, ∆∆∆, ∆∆∆∆	∆, ∆∆, ∆∆∆, ∆∆∆∆
Allan 2003	Chronic neck pain	Stretching exercises either before or after a manipulation	That same manipulation	∆	∆
Lundblad 1999	Chronic neck pain	Stabilization of the low back and pelvis, posture awareness, ergonomic training, and strength, coordination, endurance, flexibility/smoothness and rhythm exercises	No treatment	∆∆

AP: Anterior-posterior; CGH: Cervicogenic headache; GPE: Global perceived effect; QoL: Quality of life; PA: Posterior-anterior.

• Now go back to Step 1: Identify your patient, or continue to Step 3: Inform your technique.

Exercise

Unspecified/mixed duration neck pain

Exercise

Manual therapy

References

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