Neck Pain
• None
• Acupuncture , Biofeedback , Boswellia , Butterbur , Chiropractic , Chondroitin , Ginger , Glucosamine , Hypnosis , Massage , Osteopathic Manipulation , Prolotherapy , Proteolytic Enzymes , Relaxation Therapies , Turmeric , White Willow
Neck pain is a common condition, affecting millions of Americans. In many cases, x-rays do not show anything visibly wrong with the neck, suggesting that the problem is a relatively subtle one involving soft tissues. (Conversely, x-rays of people without neck pain often show arthritis; this suggests that even when positive x-ray results are found in people with neck pain, they may be unrelated.) Subtle or not in origin, the discomfort of neck pain can be severe, and lead to real disability.
The cause of soft-tissue neck pain is not known. Symptoms may follow a whiplash injury, or simply arise, apparently, from bad posture or chronic tension.
NOTE: It is unclear that any conventional medicine intervention for neck pain or whiplash speeds recovery or produces any other long term benefit. 9-10,20
Proposed Natural Treatments
Although several alternative treatments for neck pain have shown promise, none possess meaningful scientific substantiation.
Acupuncture
A 2006 review of the literature found ten controlled studies of acupuncture for chronic neck pain. 21 The pooled results suggest that acupuncture may be more effective than fake acupuncture, at least in the short term. However, overall the study quality was fairly low.
Interestingly, in a study of 177 people with chronic neck pain, fake acupuncture proved more effective than massage! 5 In a pilot study, 10 weeks of acupuncture combined with physical therapy appeared to be more effective than either acupuncture or physical therapy alone for chronic neck pain, at least over the short-term. 23
The most likely explanation for these contradictory reports is that acupuncture's effect on neck pain, if any, must be fairly modest.
Chiropractic
Millions of Americans report that chiropractic spinal manipulation has relieved their neck pain, but there is as yet little scientific evidence supporting the use of spinal manipulation for this purpose. 1,2, 11-12 Most studies have found manipulation (with or without related therapies such as mobilization or massage ) to be no more effective than placebo or no treatment. One large study (almost 200 participants) found that a special exercise program called MedX was more effective than chiropractic spinal manipulation. 3 However, a study reported in 2006 found that a single high velocity, low-amplitude (e.g., chiropractic-style) manipulation of the neck was more effective than a single mobilization procedure, in improving range of motion and pain in people with neck pain. 19
Other Treatments
Osteopathic manipulation , a form of treatment often compared to chiropractic, is widely believed to help neck pain, but there is as yet no meaningful scientific evidence to support its use for this condition. 14 Many people with neck pain use massage therapy for relief, but, again, scientific support is lacking, and one study found fake laser acupuncture more effective than massage for neck pain. 5
A treatment called prolotherapy , as well as the herb white willow , have shown promise for back pain , and might be useful for neck pain as well.
In one study, an ambitious holistic treatment regimen for neck pain (including craniosacral osteopathy along with Rosen Bodywork and Gestalt Psychotherapy) failed to prove more effective than no treatment. 16
Other herbs and supplements sometimes recommended for neck pain, either on the basis of their use for related conditions, or because of their known medical properties, include boswellia , butterbur , chondroitin , ginger , glucosamine , proteolytic enzymes , and turmeric .
Qigong is an ancient Chinese practice involving various breathing exercises and physical postures, which are thought by its practitioners to enhance general health. In one study, Qigong was no more effective than conventional physical therapy exercise techniques in the treatment of chronic, nonspecific neck pain. 22
Biofeedback , hypnosis , and relaxation therapies may offer help for pain in general.
References
1. Coulter ID. The Appropriateness of Manipulation and Mobilization of the Cervical Spine. RAND: Santa Monica, Calif; 1996.
2. Gross A, Kay T, Hondras M, et al. Manual therapy for mechanical neck disorders: a systematic review. Man Ther . 2002;7:131.
3. Nelson CF, Bronfort G, Evans R, et al. The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache. J Manipulative Physiol Ther . 1998;21:511–519.
4. White AR, Ernst E. A systematic review of randomized controlled trials of acupuncture for neck pain. Rheumatology (Oxford). 1999;38:143–147.
5. Irnich D, Behrens N, Molzen H, et al. Randomised trial of acupuncture compared with conventional massage and "sham" laser acupuncture for treatment of chronic neck pain. BMJ . 2001;322:1–6.
6. Sarig-Bahat H. Evidence for exercise therapy in mechanical neck disorders. Man Ther . 2003;8:10–20.
7. Zhu XM, Polus B. A controlled trial on acupuncture for chronic neck pain. Am J Chin Med . 2002;30:13–28.
8. Nabeta T, Kawakita K. Relief of chronic neck and shoulder pain by manual acupuncture to tender points-a sham-controlled randomized trial. Complement Ther Med . 2003;10:217–222.
9. Dziedzic K, Hill J, Lewis M et al. Effectiveness of manual therapy or pulsed shortwave diathermy in addition to advice and exercise for neck disorders: A pragmatic randomized controlled trial in physical therapy clinics. Arthritis Rheum . 2005 Apr 7 [Epub ahead of print].
10. Verhagen A, Scholten-Peeters G, Bie R, et al. Conservative treatments for whiplash. Cochrane Database Syst Rev . 2004;1:CD003338.
11. Haneline MT. Chiropractic manipulation and acute neck pain: a review of the evidence. J Manipulative Physiol Ther . 2005;28:520-5.
12. Gross AR, Hoving JL, Haines TA, et al. Manipulation and Mobilisation for Mechanical Neck Disorders. Cochrane Database Syst Rev . 2004;1:CD004249.
13. White P, Lewith G, Prescott P et al. Acupuncture versus placebo for the treatment of chronic mechanical neck pain: a randomized, controlled trial. Ann Intern Med . 2004;141:911-9.
14. Gross AR, Hoving JL, Haines TA, et al. Manipulation and Mobilisation for Mechanical Neck Disorders. Cochrane Database Syst Rev . 2004;1:CD004249.
15. Aigner N, Fialka C, Radda C et al. Adjuvant laser acupuncture in the treatment of whiplash injuries: a prospective, randomized placebo-controlled trial. Wien Klin Wochenschr . 2006;118:95-99.
16. Ventegodt S, Merrick J, Andersen NJ et al. A Combination of Gestalt Therapy, Rosen Body Work, and Cranio Sacral Therapy did not help in Chronic Whiplash-Associated Disorders (WAD) - Results of a Randomized Clinical Trial. Scientific World Journal . 2005;4:1055-68.
17. Witt CM, Jena S, Brinkhaus B et al. Acupuncture for patients with chronic neck pain. Pain. 2006 Jun 13 [Epub ahead of print].
18. Vas J, Perea-Milla E, Mendez C et al. Efficacy and safety of acupuncture for chronic uncomplicated neck pain: A randomised controlled study. Pain . 2006 Aug 22 [Epub ahead of print]
19. Martinez-Segura R, Fernandez-de-Las-Penas C, Ruiz-Saez M et al. Immediate effects on neck pain and active range of motion after a single cervical high-velocity low-amplitude manipulation in subjects presenting with mechanical neck pain: a randomized controlled trial. J Manipulative Physiol Ther . 2006;29:511-7.
20. Stewart MJ, Maher CG, Refshauge KM et al. Randomized controlled trial of exercise for chronic whiplash-associated disorders. Pain . 2006 Oct 6 [Epub ahead of print]
21. Trinh K, Graham N, Gross A, et al. Acupuncture for neck disorders. Spine . 2007;32:236-243.
22. Lansinger B, Larsson E, Persson LC, et al. Qigong and exercise therapy in patients with long-term neck pain: a prospective randomized trial. Spine. 2007;32:2415-2422.
23. Franca DL, Senna-Fernandes V, Cortez CM, et al. Tension neck syndrome treated by acupuncture combined with physiotherapy: A comparative clinical trial (pilot study). Complement Ther Med. 2008;16:268-277.
Last reviewed April 2009 by EBSCO CAM Review Board
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