Neck pain: modern approaches to the non-pharmacological treatment. Part I
Keywords:neck pain, physical therapy, physical rehabilitation, non-pharmacological methods
AbstractAcross the world, neck pain affects from 26 to 70 % of the adult population during their lifetime. Its treatment involves the use of medical and non-medical methods; however, the evidence base for their effectiveness and safety is currently considered contradictory. The purpose of this article is to summarize the data about the types and principles of various non-pharmacological treatments of the neck pain, their effectiveness and safety, as well as analysis of the latest recommendations for the use of physical methods of the neck pain treatment and discuss the authors' own experience concerning the effectiveness and safety of some non-pharmacological methods (traction, physical exercises) in the complex treatment of these patients. To achieve this goal, we’ve performed the analysis of reference sources published in the MedLine, EMBASE, Cochrane Library, Scopus, Web of Science, CyberLeninka and Russian Science Citation Index (RSCI) databases during the recent decade; those sources containing the results of modern randomized controlled trials, meta-analyses and recent Cochrane reviews about the efficacy and safety of various non-pharmacological treatments of neck pain. The first part of the article presents our analysis of effectiveness and safety of some methods of physical therapy (ergo-, reflexo-, electro-, mechano-, ultrasound therapies, traction and chiropractic, massage) for the patients with neck pain. Comparisons were made both among the individual methods of neck pain non-pharmacological treatment and between sham and absent treatment. The second part of the article presents data on the efficacy and safety of other methods of physical therapy, modern recommendations for the management of patients with neck pain, and presents the programs of therapeutic physical training developed by the authors especially for the patients belonging to various disease stages. In the first part of the article, our analysis showed that despite the sufficient number of performed studies (for instance, the randomized ones), the extant evidence of its effectiveness and safety is contradictory, due to the low quality of most studies, lack of patient blinding etc. The results of studies differ significantly in terms of their performers, disease stages, patient categories etc. It confirms the need for high-quality large prospective double-blind randomized trials of the efficacy and safety of various physical therapy methods in the treatment of patients with neck pain intended to develop the recommendations for their use.
Cohen SP. Epidemiology, diagnosis, and treatment of neck pain. Mayo Clin Proc. 2015;90(2):284-299. https://doi.org/10.1016/j.mayocp.2014.09.008.
Fejer R, Kyvik KO, Hartvigsen J. The prevalence of neck pain in the world population: a systematic critical review of the literature. Eur Spine J. 2006;15(6):834-848. https://doi.org/10.1007/s00586-004-0864-4.
Bogduk N. The anatomy and pathophysiology of neck pain. Phys Med Rehabil Clin N Am. 2011;22(3):367-vii. https://doi.org/10.1016/j.pmr.2011.03.008.
Murray CJ, Atkinson C, Bhalla K, et al. The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA. 2013;310(6):591-608. https://doi.org/10.1001/jama.2013.13805.
Parikh P, Santaguida P, Macdermid J, Gross A, Eshtiaghi A. Comparison of CPG's for the diagnosis, prognosis and management of non-specific neck pain: a systematic review. BMC Musculoskelet Disord. 2019;20(1):81. https://doi.org/10.1186/s12891-019-2441-3 .
Jun D, Zoe M, Johnston V, O'Leary S. Physical risk factors for developing non-specific neck pain in office workers: a systematic review and meta-analysis. Int Arch Occup Environ Health. 2017;90(5):373-410. https://doi.org/10.1007/s00420-017-1205-3 .
Hoe VC, Urquhart DM, Kelsall HL, Zamri EN, Sim MR. Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers. Cochrane Database Syst Rev. 2018;10(10):CD008570. https://doi.org/10.1002/14651858.cd008570.pub3 .
Trinh K, Graham N, Irnich D, Cameron ID, Forget M. Acupuncture for neck disorders. Cochrane Database Syst Rev. 2016;(5):CD004870. https://doi.org/10.1002/14651858.cd004870.pub4 .
Farag AM, Malacarne A, Pagni SE, Maloney GE. The effectiveness of acupuncture in the management of persistent regional myofascial head and neck pain: A systematic review and meta-analysis. Complement Ther Med. 2020;49:102297. https://doi.org/10.1016/j.ctim.2019.102297 .
Kroeling P, Gross A, Graham N, et al. Electrotherapy for neck pain. Cochrane Database Syst Rev. 2013;(8):CD004251. https://doi.org/10.1002/14651858.cd004251.pub5 .
Noori SA, Rasheed A, Aiyer R, et al. Therapeutic Ultrasound for Pain Management in Chronic Low Back Pain and Chronic Neck Pain: A Systematic Review. Pain Med. 2019;10.1093/pm/pny287. https://doi.org/10.1093/pm/pny287 .
Martimbianco ALC, Porfírio GJ, Pacheco RL, Torloni MR, Riera R. Transcutaneous electrical nerve stimulation (TENS) for chronic neck pain. Cochrane Database Syst Rev. 2019;12(12):CD011927. https://doi.org/10.1002/14651858.cd011927.pub2 .
Adambaev ZI, Kilichev IA. Traction therapy (literature review). Achievements of Science and Education. 2017;(20):62-70. (in Russian).
Madson TJ, Hollman JH. Cervical Traction for Managing Neck Pain: A Survey of Physical Therapists in the United States. J Orthop Sports Phys Ther. 2017;47(3):200-208. https://doi.org/10.2519/jospt.2017.6914 .
Graham N, Gross A, Goldsmith CH, et al. Mechanical traction for neck pain with or without radiculopathy. Cochrane Database Syst Rev. 2008;(3):CD006408. https://doi.org/10.1002/14651858.cd006408.pub2 .
Romeo A, Vanti C, Boldrini V, et al. Cervical Radiculopathy: Effectiveness of Adding Traction to Physical Therapy-A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Phys Ther. 2018;98(4):231-242. https://doi.org/10.1093/physth/pzy001 .
Syrotyns'ka GI. Osteohondroz shyjnogo viddilu hrebta i vegetatyvni rozlady u ljudej riznogo viku: diagnostyka ta likuvannja. Diss. kand. med. nauk [Osteochondrosis of the cervical spine and autonomic disorders in people of different ages: diagnosis and treatment. PhD in Med Sci diss.]. Kyiv; 2000. 20p. (in Ukrainian).
Gross A, Langevin P, Burnie SJ, et al. Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Database Syst Rev. 2015;(9):CD004249. https://doi.org/10.1002/14651858.cd004249.pub4 .
Juan W, Rui L, Wei-Wen Z. Chronic neck pain and depression: the mediating role of sleep quality and exercise. Psychol Health Med. 2020;1-7. https://doi.org/10.1080/13548506.2020.1724308 .
Kaka B, Ogwumike OO, Adeniyi AF, Maharaj SS, Ogunlade SO, Bello B. Effectiveness of neck stabilisation and dynamic exercises on pain intensity, depression and anxiety among patients with non-specific neck pain: a randomised controlled trial. Scand J Pain. 2018;18(2):321-331. https://doi.org/10.1515/sjpain-2017-0146 .
How to Cite
Copyright (c) 2020 N.V. Grygorieva, V.V. Povoroznyuk, S.V. Nemerska
This work is licensed under a Creative Commons Attribution 4.0 International License.