Neck Pain

Kay, TM et al. Exercises for mechanical neck disorders. Cochrane Database Syst Rev. Jul 20; (3): CD004250 (2005)

Neck disorders are common, limit function, and are costly to individuals and society. Exercise therapy is a commonly used treatment for neck pain. This review was performed to assess the effectiveness of exercise therapy to relieve pain, or improve function, disability, patient satisfaction, and global perceived effect in adults with mechanical neck disorders (MND).

Selected studies were randomized [RCTs] or quasi-randomized trials and investigated the use of exercise therapy as a treatment in adults with MND with or without headache or radicular signs and symptoms.

Thirty-one trials were selected, 19% (van Tulder criteria) to 35% (Jadad scale) had high quality.

1.       There is strong evidence of benefit favoring a multimodal care approach of exercise combined with mobilization or manipulation for subacute and chronic MND with or without headache, in the short and long term.

2.       There is moderate evidence of benefit that neck strengthening exercises reduce pain, improve function and global perceived effect for chronic neck disorder with headache in the short and long term.

3.       There is limited evidence of benefit that acute range of motion (AROM) may reduce pain in acute MND (whiplash associated disorder {WAD}) in the short term.

4.       There is unclear evidence regarding the impact of a stretching and strengthening program on pain, function and global perceived effect for MND. However, when this stretching and strengthening program focuses on the cervical or cervical and shoulder/thoracic region, there is moderate evidence of benefit on pain in chronic MND and neck disorder plus headache, in the short and long term.

5.       There was evidence of no difference between the different exercise approaches.