11/16/2009 - Articles

Neck pain - patient preference should guide treatment

By: Susan Aldridge, medical journalist, PhD

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Neck pain

Neck pain is common, with around 15% of the population reporting a new episode each year.  Put another way,  around half of the adult population will have neck pain during any six month period and for 5% the pain causes some disability.  Recurrence and persistence of neck pain are also only too common.  There is a form of neck pain called cervical radiculopathy which is even more troublesome.  Cervical radiculopathy radiates into the arm and causes numbness, weakness and tingling in the arm and shooting pains.  Fortunately, cervical radiculopathy is one of the less common forms of neck pain.

In a new study, researchers from The Netherlands look at how three treatment approaches work in improving neck pain caused by cervical radiculopathy.  A group of over 200 patients with this kind of neck pain received either immobilisation (via a semi-rigid collar),  physiotherapy and exercise, or no treatment (the ‘wait and see’ approach).  All three groups had improved after six weeks but the benefits were greater in the two active treatment groups.  This is interesting – because the two treatment approaches are the opposite (immobilise versus mobilise).  And, if the person with neck pain is prepared to be patient, they can even manage without treatment and still hope for improvement.  There has been some evidence, in the past, against the use of collars, because they encourage the patient to adopt a ‘sick’ role and also they do not really immobilise the spine.  But they are cheaper than physiotherapy.  These new findings suggest that neck pain is still a bit of a mystery.  But at least patient preference can be allowed to play a role in how neck pain is treated, as there are three approaches which work.

 

Source:

Kuijer B et al Cervical collar or physiotherapy versus wait and see policy for recent onset cervical radiculopathy: randomised trial BMJ 2009;339:b3883

Created on: 11/06/2009
Reviewed on: 11/16/2009

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Anonymous wrote 2 years 11 weeks ago

Hello
During our fitness program we often forget neck exercise. According to me regular neck exercise is good with your warm up exercise.This is a good post about neck pain and I came to know many new things about it.Thank you..

myrtille

Anonymous wrote 2 years 13 weeks ago

I am surprised as well. Typically chiropractic treatment is the best initial treatment for cervical radiculopathy. The simple fact is that there is pressure on nerve(s). Improving posture and neck alignment will make the biggest difference.
Every case will be slightly different as far as to mobilize or immobilize, or with which exercise to use. Mostly all should however use good neck pillow, and use a chiropractor for help. A physiatrist, PT, or massage therapist are also professionals that can be consulted.
http://www.neckpainsupport.com

Anonymous wrote 2 years 14 weeks ago

Did the physiotherapy include cervical traction that helps with cervical radiculopathy? What kind of exercises were given to the patient? And were there any modalities used to decrease neck discomfort?
Neck Exercises, Neck Exercises

Anonymous wrote 2 years 14 weeks ago

Here's also a link for neck exercises: www.neckexercises.net

Anonymous wrote 2 years 14 weeks ago

I find it interesting that Chiropractic care is not listed in this study. Chiropractors are specialists in dealing with the spine and I have had really good results at treating cervical radiculopathy. People with this condition need to seek the advice of a good chiropractor.
Reno Chiropractor
www.QuigleyChiro.com