Fifty percent of the adult population experiences neck pain each year. With such a high prevalence it is important for patients to know what treatments work best for neck pain. This article is going to discuss the top 4 treatments for acute neck pain (less than 3 months). These recommendations were made by the Ontario Protocol for Traffic Injury Management (OPTIMa – March 2016) collaboration. For a full synopsis of their recommendations for acute pain, click here.
1. The top 4 treatments for acute neck pain: education and reassurance.
With every injury – the psychological implications on a patient can not be ignored. Numerous studies have shown that patients who have a better understanding about the nature, management and clinical course of neck pain tend to do better than patients who are uninformed. This is the whole reason I do these artciles for my patients.
When it comes to acute neck pain, patients should be made aware that the majority of neck pain cases are self-limiting. This means that if the patient does nothing, the majority of time they will still get better. The goal of therapy is to reduce the duration and intensity of symptoms.
Nevertheless, patients should not just receive education, as it is less effective than a combination of spinal manipulation and range of motion (ROM) exercises.
2. The top 4 treatments for acute neck pain: range of motion exercises.
For pretty much any injury the research is unanimous, immobility produces worse long-term results than mobility. Therefore, ROM exercises should be taught to neck pain patients by healthcare providers. ROM exercises should be performed, resistance free, 5-10 times (repetitions) and up to 6-8 times per day (sets).
ROM exercises should be performed in a slow and controlled manner. They should involve the neck and shoulders. These exercises should include neck retraction, forward bending, extension, side to side bending and rotation. Scapular retraction ROM exercises should also be included.
3. The top 4 treatments for acute neck pain: Chiropractic Adjustments & exercises.
The majority of position statements on neck (including OPTIMa) and low back pain recommend chiropractic adjustments in combination with exercises. This is because researchers have found that the combination of chiropractic adjustments and ROM exercises is more cost effective than exercises with ultrasound and electrotherapy. Chiropractic adjustments and exercise is also more effective than advice and medication (analgesics).
Optima recommends six sessions of chiropractic adjustments and ROM exercises over an eight-week period.
4. The top 4 treatments for acute neck pain: medications.
When it comes to medication for pain management most expert now recommend taking the lowest effective dose for the shortest period of time. Patients should also avoid taking opioids if possible. This sentiment is supported by the World Health Organization and their non-opioid first ‘step’. Therefore, excluding opioids the medications that have been shown to be beneficial for acute neck pain are muscle relaxants.
According to OPTIMa there is insufficient evidence for prescribing NSAIDs for acute neck or spinal pain. In addition, recent studies have found Tylenol to be ineffective at managing acute neck or spinal pain.
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