The results directly contradict a 2008
recommendation by the Neck Pain Task Force in Canada. Instead, the
new research "suggests that people with neck pain have many options
when choosing how to improve it," Janet Freburger told Reuters
"There were no major differences between the types of exercise
programs, or (evidence) that exercise in general was beneficial,"
said Freburger, an associate director at the Sheps Center for Health
Services Research at the University of North Carolina at Chapel
Hill. She was not involved in the research.
After reviewing 10 randomized controlled trials for neck pain
treatment published since 2008, researchers concluded that certain
treatments may be helpful for specific types of neck pain, depending
on whether it is mild or severe.
"If you have neck pain, whether it started two days ago or two weeks
ago, one of the best things you can do is gently move and stretch
your neck muscles," said study author Dr. Pierre Côté, an
epidemiologist at the University of Ontario Institute of Technology
"Longer lasting and more severe neck pain usually requires more
work," Côté added.
Neck pain is the fourth leading cause of chronic disability in the
U.S., the researchers write in The Spine Journal.
What the researchers did find is that certain exercises appear to
help specific kinds of neck pain.
Two randomized control trials — considered medicine's gold standard
for evidence — found that qigong, a type of gentle stretching and
breathing, reduced low-grade neck pain, when patients were compared
to a group that did not do qigong.
Another trial appeared to show that Iyengar yoga, which includes
classical yoga poses, helped with milder forms of neck pain.
Interestingly, one study found that patients who were supervised
during strengthening exercises did no better than a neck pain group
assigned to do exercises at home.
[to top of second column]
For those who suffered from whiplash-associated neck pain, a
study found little difference between a group assigned to do
exercises and a group just given advice about self care.
Overall, the trials found that for mild neck pain (considered
grades 1 and 2), unsupervised range of motion exercise,
over-the-counter painkillers and manual massage were about equally
For persistent grade 1 and 2 neck pain and whiplash pain, supervised
qigong and combined strengthening, range of motion and flexibility
exercises are better than doing nothing.
"One of the key messages is: move your neck and your condition will
probably benefit at least some," Côté said.
"And before physicians prescribe an exercise program for their
patients, they should discuss different options with them," he
"If a patient is not interested in yoga, then he or she could try
The Spine Journal, online Feb. 18, 2014.
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