Affirmative Nod in Favor of Active Treatments for Chronic Neck Pain
Health providers rely on results of carefully designed research studies to know which types of treatments will best help their patients. Researchers pursuing this quest recently compared the benefits of three types of programs for patients with chronic neck pain.
Three groups of patients were randomly assigned to receive different forms of treatment. One group received active treatments twice each week for 12 weeks with direct help from a physical therapist. They also received relaxation training and neck posture and coordination exercises. They were encouraged to work through fears of pain that might otherwise keep them from doing normal activity. A second group was given two separate lectures about neck pain, got a handout of exercises to do at home, and kept an exercise diary of their progress. Participants in the third group attended one lecture about neck problems. They then took home information about neck exercises to do on their own.
Before starting their treatment programs, all the patients completed a survey with basic physical information and information about their pain levels, use of medications, and ability to do daily activities. The patients answered questions about work, including how much and how often they had to lift and whether they got adequate breaks or felt rushed. Patients also reported their feelings and attitudes about their pain, and whether it was keeping them from their normal activities. The researchers then measured how well each person's neck moved and how much pain patients had when pressure was place on certain neck muscles. The surveys, motion measurements, and pressure scores were rechecked after three months and then again at 12 months.
People seen for active treatments with a physical therapist showed the best results. They had fewer neck symptoms, reported better general health, and even showed better moods and feelings of well-being. They reported doing better at work, a finding the authors feel may "have an affect on absenteeism and costs due to neck pain." All these benefits were reported at three months and 12 months.
The measurements of neck motion and pressure responses didn't change much in any of the groups. However, individual reports of benefits were highest in the active group. People in the active group had better results than those in the home-exercise group, who in turn had better results than people who only got a lecture and information about exercise.
More research is needed. But this study indicates the benefits of an active program. It is noteworthy that people who are monitored in their exercise program do better than patients who merely get a recommendation for exercise.
Simo Taimela, MD, DMSc, et al. Active Treatment of Chronic Neck Pain: A Prospective Randomized Intervention. In Spine. April 15, 2001. Vol. 25. No. 8. Pp. 1021-1027.
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