Neck pain represents a major problem for people throughout the world with considerable negative impact on individuals, families, communities, healthcare systems, and businesses. In fact, it's estimated that up to 70% of the general population will have neck pain at some point in life. Recovery within the year from neck pain ranges between 33% and 65%, AND relapses are common with neck pain patients. Generally, neck pain is more common in women, and more prevalent in high-income countries and in urban regions. The greatest risk of developing neck pain occurs between 35 and 49 years of age. Since neck pain, very similar to low back pain, is very common and likely to recur over and over again, the question is, what is the best course of action regarding treatment?
A 2013 study on neck pain patients compared the effectiveness of manual therapy performed by a chiropractor, physical therapy performed by a physical therapist (PT), and medical care performed by medical physician (MD). The success rate determined at the seventh week was TWO TIMES BETTER for the manual therapy/chiropractic group (68.3%) compared with the medical care group. Those receiving manual therapy also had fewer absences from work compared to both the medical and PT treated groups. Lastly, both the manual therapy and PT groups used less pain relief medication compared with the medically treated group. Another study looked at the multiple approaches that chiropractors use for treating patients with neck pain to determine the “best” approach a chiropractor can use. They reported 94% had improvement or less neck pain after just one treatment when the mid-back (thoracic spine) was also adjusted. Similarly, after receiving two treatments over a one-week time frame, the group receiving mid-back adjustments (vs. the group who did not) reported lower pain and disability scores. A similar study concluded that the best results occurred when the neck, upper back/lower neck, and mid-back were adjusted. This group, when compared to neck adjustments alone, reported greater reductions in disability scores. Thus, having the cervical spine, upper back, and mid-back all adjusted appears to yield quicker, more satisfying results than neck adjustments alone.
What about the role of exercise in the management of neck pain patients? In November 2012, a systematic review of manual therapies for nonspecific neck pain reported that the addition of neck exercises to a treatment plan provided more benefits than spinal manipulation alone. Similarly, in September 2012 (The Annals of Internal Medicine), chiropractic adjustments were compared against exercise and pain medication treatment groups involving 272 patients tracked over a one-year time frame after a 12-week treatment. Both the chiropractic and exercise groups experienced the most significant pain reduction when compared to the medication treated group with more than double the likelihood of complete pain relief. The chiropractic and exercise groups also had the best short and long term results, but researchers found ONLY the chiropractic group experienced benefits that lasted a year or longer. The authors (Bronfort, et. al) reported the success of chiropractic treatment stems from its ability to address the CAUSE of the problem rather than simply addressing the symptoms!
