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X ! ' ( ( , 4 0 4 ( H8 ' H8 ( ( Table 3. Systematic reviews of neck pain non-invasive intervention studies accepted in the best evidence synthesis: The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.
Author et al. (Year)
Study Design
Access #Setting and Subjects
(Number enrolled)Intervention GroupsOutcomes measured and Follow-upKey findingsBronfort et al. (2001) ADDIN REFMGR.CITE Bronfort2001678Efficacy of spinal manipulation for chronic headache: a systematic reviewJournal678Efficacy of spinal manipulation for chronic headache: a systematic reviewBronfort,G.Assendelft,W.J.Evans,R.Haas,M.Bouter,L.2001/9*Chiropracticmt [Methods]*Manipulation,Spinal*Migraineth [Therapy]*Tension Headacheth [Therapy]AnalgesicsChiropracticChronic DiseaseClassificationClinical TrialClinical TrialsConfounding Factors (Epidemiology)Databases,BibliographicDisabilityFollow Upfollow-upHandHeadacheHealthHumanMassageMedicineMEDLINEMigraineNursingPainPain MeasurementPatientsPhysical Therapy TechniquesQuality of LifeRandomized Controlled TrialsResearchResearch DesignRestReviewSciencespinal manipulationSupport,Non-U.S.Gov'tSystematic ReviewTherapyTreatment OutcomeUniversitiesNot in File457466Journal of Manipulative & Physiological Therapeutics247R-R1255MedlineJournal of Manipulative & Physiological Therapeutics12
Systematic review
Systematic review of RCTs of spinal manipulative therapy for tension, migraine, or cervicogenic headache identified from Medline (1966-1998) and Embase (1974-1998), plus all available data from Cinahl, the Chiropractic Research Archives Collection, and the Manual, Alternative, and Natural Therapies Information System, and hand searching of non-indexed chiropractic, osteopathic, and manual medicine journals.
(N=9 studies; 683 subjects; 1 cervicogenic and 1 cervicogenic-like headache studies with 53 and 30 subjects, respectively)
Spinal manipulative therapy compared with other interventions or placebo.Outcomes: Patient-rated outcomes including pain severity, frequency, duration, improvement, use of analgesics, disability, and quality of life.
Follow-up: 3 weeks (cervicogenic headache studies) to 3 months (all studies).Moderate evidence that spinal manipulative therapy is more efficacious than massage for treatment of cervicogenic headache, but not better when added to massage for episodic tension-type headache.Bronfort et al. (2004) ADDIN REFMGR.CITE Bronfort20042136Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis.Journal2136Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis.Bronfort,G.Haas,M.Evans,R.L.Bouter,L.M.2004/5*Evidence-Based Medicine*Low Back Painrh [Rehabilitation]*Manipulation,Spinalmt [Methods]*Neck Painrh [Rehabilitation]*Range of Motion,ArticularArticleAttentionBackBack PainClassificationClinical TrialClinical TrialsDatabasesDatabases,FactualDiathermyDisabilityExerciseFamilyFollow Upfollow-upGuidelinesHealthHumansLow Back PainMeta-AnalysisMethodsNeckNeck PainPainPatientsPhysical TherapyRandomized Controlled TrialsrecoveryResearchResearch Support,Non-U.S.Gov'tReviewSciencespinal manipulationSurgerySystematic ReviewTherapyTimeTreatment OutcomeUniversitiesNot in File335356Spine43R-RScientifically AdmissibleReview/Systmeatic Review/Meta-AnalysisIntervention1474Spine13
Systematic review
(Best Evidence Synthesis)
Systematic review of RCTs published in English, Danish, Swedish, Norwegian and Dutch and including 10 or more subjects per group receiving spinal manipulative therapy or mobilization for low back or neck pain identified from Medline (1966-2002), Embase (1974-2002), Cinahl, and Chiropractic Research Archives Collection, and the Manual, Alternative, and Natural Therapies Information System, and admitted into the BES according to eight criteria.
(N=69 met inclusion criteria; 43 admitted to BES)
Spinal manipulative therapy (high-velocity, low-amplitude manual thrusts to spinal joints beyond passive range of motion) or mobilization (application of manual force within the passive range of motion not involving a thrust) for low back or neck pain.Outcomes: Patient-oriented outcomes including patient-rated pain, disability, global improvement, and recovery time.
Follow-up: Variable.Inconclusive evidence for SMT or mobilization in acute neck pain; moderate evidence that (1) SMT/mobilization is better than GP care in the short term and (2) SMT similar to high-tech rehabilitative exercise in short and long term for chronic neck pain, and (3) mobilization superior to physical therapy and GP care, and (4) similar to SMT in short and long term for mix of acute and chronic neck pain; and limited evidence that SMT is inferior to physical therapy in short and long term for mix of acute and chronic neck pain.Carlsson et al. (1999) ADDIN REFMGR.CITE Carlsson19996669Evidence based physiotherapy: Patients with neck disordersReport6669Evidence based physiotherapy: Patients with neck disordersCarlsson,JNorlander,SRundcranz,BLJonsson,Tet al1999NeckNeck disordersPatientsPhysiotherapyNot in File101244
Systematic review
Systematic review of RCTs of treatments given by physiotherapists for acute and chronic neck pain and neck pain following whiplash injury and cervicogenic headache identified from Medline, Cinahl, Cochrane Controlled Trials Register, Cochrane Database of Systematic Reviews and Protocols, Embase, Psychinfo, and Swemed (no date ranges given, but no articles later than 1998) and published in English, German, or Nordic languages.
(N=38 studies [including one economic study], 9 considered high quality; number of subjects varies according to condition)
EMG-biofeedback, manipulation, chiropractic, orthopedic manual therapy (OMT), active and passive exercises, mobilization, massage, traction, acupuncture, TENS, heat and cold treatment, ultrasound, coordination exercises, neck school, PEMT, neck collar, low-level laser therapy, infrared light therapy, aerobic and strengthening training, power training of neck and shoulder muscles, relaxation and stress-reduction programs, and body awareness and self care.Outcomes: No specific outcomes, though analyses stratified by acute vs. chronic pain, and whiplash early vs. late stage.
Follow-up: Variable.Few neck-pain treatments given by physiotherapists have been shown to reduce pain; majority of treatments have not been evaluated with rigorous methodology; review supports OMT for chronic neck pain and active and passive movements in early stage after whiplash; weaker evidence for OMT in acute neck pain and for traction, physical exercise, and acupuncture in chronic neck pain.Chow and Barnsley (2005) ADDIN REFMGR.CITE Chow20052184Systematic review of the literature of low-level laser therapy (LLLT) in the management of neck pain.Journal2184Systematic review of the literature of low-level laser therapy (LLLT) in the management of neck pain.Chow,R.T.Barnsley,L.2005/7*Laser Therapy,Low-Level*Neck Painth [Therapy]ArticleAustraliaDatabasesHealthHumansMedicineMeta-AnalysisMethodsNeckNeck PainNew South WalesPainPhysiotherapyRandomized Controlled TrialRandomized Controlled TrialsRCTReviewScienceSystematic ReviewTherapyTreatment OutcomeNot in File4652Lasers in Surgery & Medicine371R-RScientifically AdmissibleReview/Systematic Review/Meta-AnalysisIntervention1612MedlineLasers in Surgery & Medicine15
Systematic review
Systematic review of parallel (non-crossover) RCTs of low-level laser therapy (LLLT) for treatment of acute or chronic mechanical neck pain in persons >16 years old identified from Medline (1966-2004), Premedline (2004), Embase (1974-2004), Cinahl (1982-2004) Biological Abstracts (1984-2004), Cochrane Database of Systematic Reviews (2004 update), Cochrane Central Register of Controlled Trials (2004 update), ACP Journal Club (2004 update), Database of Abstracts of Review of Effects (2004 update), PEDro (earliest ref. 1929), Science Citation Index (1980-2004), BIOSIS (1980-2004), and AMED (1985-2004), and published in English.
(N=5; 273 subjects)
Low-level laser therapy of any wavelength not involving stimulation of acupuncture points.Outcomes: Primary change in pain scores before and after treatment; others range of movement, function/disability measures, quality of life, and adverse effects.
Follow-up: Immediate to 6 months.Limited evidence for short-term effectiveness of infrared laser in the treatment of acute and chronic neck pain.Conlin et al. (2005) ADDIN REFMGR.CITE Conlin20056663Treatment of whiplash-associated disorders--part II: Medical and surgical interventionsJournal6663Treatment of whiplash-associated disorders--part II: Medical and surgical interventionsConlin,A.Bhogal,S.Sequeira,K.Teasell,R.2005*Physical Therapy Modalities*Whiplash Injuriessu [Surgery]*Whiplash Injuriesth [Therapy]ArticleCanadacervicalClinical TrialClinical TrialsDatabasesDecompressiondiscectomyHealthHumansInjectionsInjuriesLondonMeta-AnalysisMethodsNeckPainQuebecRandomized Controlled TrialRandomized Controlled TrialsRCTResearchReviewSystematic ReviewWhiplash Injuriesco [Complications]Not in File3340Pain Research & Management10Pain Research & Management16
Systematic review
Systematic review of RCTs and observational studies on noninvasive interventions for acute (<3 months) and chronic (>3 months) whiplash-associated disorders identified from Medline, Cinahl, and CENTRAL and published between Jan. 1993 and July 2003.
(N=18 studies [8 RCTs and 10 non-RCTs])Noninvasive interventions in the selected studies categorized as exercise alone, multimodal with exercise, mobilization, strength training, pulsed magnetic field treatment, and chiropractic manipulation.Outcomes: Pain intensity, disability, cervical range of motion, coping, self efficacy, global functioning, medication use, and return to work.
Follow-up: 1 week to 6 months.Consistent evidence in support of mobilization for pain reduction and range of motion improvement, and against exercise alone for range of motion improvement in acute WAD; conflicting evidence regarding multimodal care with exercise; limited or conflicting evidence for all other noninvasive interventions for acute or chronic WAD.
Fernandez-de-las-Penas (2005) ADDIN REFMGR.CITE Fernandez-de-las-Penas2005107Spinal manipulative therapy in the management of cervicogenic headacheJournal107Spinal manipulative therapy in the management of cervicogenic headacheFernandez-de-las-Penas,C.Alonso-Blanco,C.Cuadrado,M.L.Pareja,J.A.2005/10*Manipulation,Chiropractic*Post-Traumatic Headacheth [Therapy]ArticleFemaleHeadacheHumansMaleMedicineOccupational TherapyPatientsPhysical MedicinePhysical TherapyRandomized Controlled TrialsRehabilitationspinal manipulationTherapyTreatment OutcomeNot in File12601263Headache459R-RScientifically AdmissibleReview/Systematic Review/Meta-AnalysisIntervention1541MedlineHeadache18
Systematic review
Systematic review of RCTs of spinal manipulative therapy for management of cervicogenic headache identified from Medline, Embase, Amed, Mantis, Cinahl, and Cochrane databases; patients diagnosed according to the first edition of the Classification of Headache Disorders of the International Headache Society (IHS) or Sjaastad et al.s diagnostic criteria.
(N=3 articles; 2 studies; 253 subjects)
Spinal manipulative therapy, spinal manipulation, cervical manipulation, or chiropractic manipulation alone or in combination with other interventions.Outcomes: Headache intensity, frequency and/or duration.
Follow-up: 1 week to 12 months.Level 1 (strong) evidence for spinal manipulative therapy on reducing headache intensity and duration and on medication intake; level 3 (limited) evidence for reducing headache frequency; additional well-designed RCTs are needed to confirm or refute these findings.Geurts et al. (2001) ADDIN REFMGR.CITE Geurts2001688Efficacy of radiofrequency procedures for the treatment of spinal pain: a systematic review of randomized clinical trialsJournal688Efficacy of radiofrequency procedures for the treatment of spinal pain: a systematic review of randomized clinical trialsGeurts,J.W.van Wijk,R.M.Stolker,R.J.Groen,G.J.2001/9*Low Back Painrt [Radiotherapy]*Neck Painrt [Radiotherapy]*Radio Wavestu [Therapeutic Use]AnalysisBackBack PaincervicalChronic DiseaseChronic PainClinical TrialClinical TrialsControlled StudyDenervationHumanInjuriesLow Back PainMethodsNervous SystemNetherlandsPainrandomized clinical trialRandomized Controlled TrialRandomized Controlled TrialsReviewSystematic ReviewNot in File394400Regional Anesthesia & Pain Medicine265R-RScientifically AdmissibleReview/Systematic Review/Meta-AnalysisIntervention1143MedlineRegional Anesthesia & Pain Medicine19
Systematic review
Systematic review of RCTs of radiofrequency procedures in the treatment of spinal pain identified from Medline (1966 through 2000), Embase (1989 through 2000), the Cochrane Library (1988 through 1999), the Dutch Central Catalogue (1988 through 1999), and Current Contents (Aug. 1999 through Oct. 2000).
(N=6 studies [3 neck-related; 105 subjects])
Radiofrequency procedures of the dorsal root ganglion and zygapophyseal joints in the treatment of pain associated with whiplash, occipital neuralgia, cervicobrachialgia, and discogenic neck pain.Outcomes: Pain relief.
Follow-up: Variable.Limited evidence in support of radiofrequency neurotomy in the treatment of chronic cervical zygapophyseal joint pain following whiplash, and for radiofrequency heating of the dorsal root ganglion for chronic cervicobrachialgia.Gross et al. (1996) ADDIN REFMGR.CITE Gross19961964Conservative management of mechanical neck disorders. A systematic overview and meta-analysisJournal1964Conservative management of mechanical neck disorders. A systematic overview and meta-analysisGross,A.R.Aker,P.D.Goldsmith,C.H.Peloso,P.1996/7/30Acupuncture TherapyAdultArticleCanadaChiropracticDatabases,BibliographicDrug TherapyEducationExerciseHospitalsHumanInjuriesManipulation,Orthopedicmanual therapyMedicineMeta-AnalysisMethodsNeckNeck disordersNeck InjuriesNeck PainOntarioPainPatient EducationPhysical MedicinePhysical TherapyRandomized Controlled TrialRandomized Controlled TrialsRCTRehabilitationReproducibility of ResultsResearchRestSchoolsScienceSupport,Non-U.S.Gov'tTherapyTherapy.UniversitiesWounds and InjuriesNot in File34457Online Journal of Current Clinical TrialsDoc No 200-201R-RScientifically AdmissibleReview/Systematic Review/Meta-AnalysisIntervention984MedlineChedoke-McMaster Hospitals & Schools of Rehabilitation Science, McMaster University, Hamilton, Ontario, CanadaOnline Journal of Current Clinical Trials110
Systematic review and meta-analysis
Aker et al. (1996) ADDIN REFMGR.CITE Aker19966660Conservative management of mechanical neck pain: systematic overview and meta-analysisJournal6660Conservative management of mechanical neck pain: systematic overview and meta-analysisAker,P.D.Gross,A.R.Goldsmith,C.H.Peloso,P.1996/11/23*Neck Painth [Therapy]*Physical Therapy Modalities0 (Anti-Inflammatory Agents)Anti-Inflammatory Agentstu [Therapeutic Use]ArticleCanadaChiropracticClinical TrialClinical TrialsDatabasesEducationEnglandGov'tHumansMedicineMeta-AnalysisMethodsNeckNeck disordersNeck PainNeck Paindt [Drug Therapy]Neck Painrh [Rehabilitation]OntarioPainPatient EducationPatientsPhysical MedicineRandomized Controlled TrialsResearchReviewTranscutaneous Electric Nerve StimulationTreatment OutcomeNot in File12911296BMJ3137068BMJ11
Systematic review and meta-analysis of RCTs and non-randomized (pre-post) studies on noninvasive, nonsurgical treatments for neck disorders in persons 18 years or older identified from Medlars, Embase, Chirolars, Index to Chiropractic Literature, and Cinahl or from manual searches or content experts and published from 1985 through Dec. 1993.
(N=32 studies [24 RCTs and 8 non-RCTs])Conservative interventions categorized as: manual therapies (manipulation, mobilization, and massage); physical medicine modalities (exercise, ice, rest, heat, electrotherapeutic modalities, collar, traction, and acupuncture); drug therapies (analgesic, anti-inflammatory, muscle relaxant, and psychotropic medication); and patient education (ergonomics, neck school or postural advice).Outcomes: Pain and range of motion.
Follow-up: Variable.Four meta-analyses were conducted: (1) 5 manual therapy RCTs, (2) 4 physical medicine modality RCTs, (3) 2 electromagnetic therapy trials, and (4) 2 laser therapy trials; evidence supports manual therapies in combination with other treatments for short-term neck-pain relief; limited support for electromagnetic therapy and against laser therapy; little or no evidence for or against other treatments.
Gross et al. (2002, 2003, 2004) ADDIN REFMGR.CITE Gross2002590Manual therapy for mechanical neck disorders: a systematic review.Journal590Manual therapy for mechanical neck disorders: a systematic review.Gross,A.R.Kay,T.Hondras,M.Goldsmith,C.Haines,T.Peloso,P.Kennedy,C.Hoving,J.2002/8*Manipulation,Orthopedicmt [Methods]*Neck Injuriesrh [Rehabilitation]*Neck Painrh [Rehabilitation]AdultCanadaExerciseExercise Therapymt [Methods]HeadacheHeadacheet [Etiology]Headacheth [Therapy]HealthHumanmanual therapyMassageMedicineMethodsNeckNeck disordersNeck Injuriesco [Complications]Neck Painet [Etiology]PainPain MeasurementPatient SatisfactionPhysical MedicineRandomized Controlled TrialsResearch DesignRestReviewRiskScienceSupport,Non-U.S.Gov'tSystematic ReviewTherapyTreatment OutcomeNot in File131149Manual Therapy73R-RScientifically AdmissibleReview/Systematic Review/Meat-AnalysisIntervention916MedlineManual Therapy1Gross20041892Manipulation and mobilisation for mechanical neck disorders.Journal1892Manipulation and mobilisation for mechanical neck disorders.Gross,A.R.Hoving,J.L.Haines,T.A.Goldsmith,C.H.Kay,T.Aker,P.Bronfort,G.Cervical Overview Group2004*Manipulation,Orthopedicmt [Methods]*NeckAdultAnalysisAttentionData CollectionDatabasesExerciseHeadacheHumansLanguageMedicineMEDLINENeckNeck disordersNeck Painrh [Rehabilitation]PainPatient SatisfactionPhysical MedicineRandomized Controlled TrialsRCTRecovery of FunctionRiskNot in FileCochrane Database of Systematic Reviews1CD004249R-RScientifically AdmissibleReview/Systematic Review/Meta-AnalysisIntervention917Cochrane Database of Systematic Reviews1Gross20049A Cochrane review of manipulation and mobilization for mechanical neck disorders.Journal9A Cochrane review of manipulation and mobilization for mechanical neck disorders.Gross,A.R.Hoving,J.L.Haines,T.A.Goldsmith,C.H.Kay,T.Aker,P.Bronfort,G.Cervical Overview Group2004/7/15*Manipulation,Spinal*Neck Painth [Therapy]*Physical Therapy ModalitiesAdultAgedArticleCanadaCombined Modality TherapyDatabasesEvidence-Based MedicineExerciseExercise TherapyFemaleGov'tHeadacheHeadacheet [Etiology]Headacheth [Therapy]HealthHumansMaleManipulation,ChiropracticMethodsMiddle AgedNeckNeck disordersNeck Painco [Complications]OntarioPainPain MeasurementPatient SatisfactionRandomized Controlled TrialsRecovery of FunctionRehabilitationResearchReviewRiskScienceSpineSystematic ReviewTreatment OutcomeUnited StatesUniversitiesNot in File15411548Spine2914Scientifically AdmissibleReview/Systematic Review/Meta-AnalysisIntervention1475Spine111-13
Systematic review (Cochrane Collaboration)
Systematic review of all RCTs or quasi-RCTs of manipulation or mobilization for mechanical neck disorders in adults (including WAD categories I and II, myofascial neck pain, and degenerative changes), neck disorder with headache, and neck disorders with radicular findings (including WAD category III) identified from CENTRAL, Medline, Embase, Mantis, Cinahl, and ICL from respective starting dates to March 2002.
(N=33 studies; 2952 subjects)
Cervical manipulation and cervical mobilization, alone or in combination with other treatments. Various comparison groups included placebo, other treatments, and waiting list controls.Outcomes: Pain relief, disability/function, patient satisfaction, and global perceived affect.
Follow-up: Immediate to 2 years.Short and long-term benefits of multimodal care (manipulation or mobilization plus exercise) for subacute or chronic mechanical neck disorders with or without headache; no benefit or relative benefit of manipulation and mobilization alone or in combination with other modalities; insufficient evidence regarding neck disorders with radicular findings. Haraldsson et al. (2006) ADDIN REFMGR.CITE Haraldsson200610Massage for mechanical neck disordersJournal10Massage for mechanical neck disordersHaraldsson,B.G.Gross,A.R.Myers,C.D.Ezzo,J.M.Morien,A.Goldsmith,C.Peloso,P.M.Bronfort,G.Cervical Overview Group2006*Massagemt [Methods]*Neck Painth [Therapy]AdultAdverse EffectsAnalysisArticleCanadaData CollectionDatabasesEnglandFollow Upfollow-upHumansLanguageMassageMEDLINENeckNeck disordersNeck PainPainPatient SatisfactionRandomized Controlled TrialsReviewRiskStandardsTherapyTimeNot in FileCochrane Database of Systematic Reviews3CD0048711760Cochrane Database of Systematic Reviews114
Ezzo et al. (2007) ADDIN REFMGR.CITE Ezzo20076409Massage for mechanical neck disorders: A systematic reviewJournal6409Massage for mechanical neck disorders: A systematic reviewEzzo,J.Haraldsson,B.G.Gross,A.R.Myers,C.D.Morien,A.Goldsmith,C.H.Bronfort,G.Peloso,P.M.2007*Massage*Neck Painth [Therapy]AdultBaltimoreClinical TrialData BaseDatabasesFollow Upfollow-upHealth Care CostHumanLanguageMassageMethodsNeckNeck disordersNeck PainPainPatient SatisfactionPriority JournalReviewRiskStandardsSystematic ReviewTherapy EffectTimeUnited StatesNot in File353362Spine3231760Spine17
Systematic review (Cochrane Collaboration)
Systematic review of all RCTs or quasi-RCTs of massage for mechanical neck disorders in adults identified without language restriction from Cochrane CENTRAL, Medline, Embase, Mantis, Cinahl, and ICL databases from their inception to Sept. 2004.
(N=19 studies)
Massage either as a stand-alone treatment or as part of a multimodal intervention.Outcomes: Pain, function, patient satisfaction, cost of care, and adverse effects of treatment.
Follow-up: Variable.Six trials focused on massage as a stand-alone treatment; 14 included massage as part of multimodal care; studies were too heterogenous to pool, the majority were of low quality, and the results inconsistent; no recommendations made because of uncertain effectiveness.Hoving et al. (2001) ADDIN REFMGR.CITE Hoving20011527A critical appraisal of review articles on the effectiveness of conservative treatment for neck painJournal1527A critical appraisal of review articles on the effectiveness of conservative treatment for neck painHoving,J.L.Gross,A.R.Gasner,D.Kay,T.Kennedy,C.Hondras,M.A.Haines,T.Bouter,L.M.2001/1/15ArticleClinical TrialDatabasesLanguageMedicineMethodsNeckNeck disordersNeck PainNetherlandsPainPopulationResearchReviewSystematic ReviewTherapyTractionNot in File196205Spine262Y (The list was sent in November 2002)Scientifically admissibleReviewIntervention54MedlineFaculty of Medicine, Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands. j.l.hoving.emgo@med.vu.nlSpine115
Systematic review of systematic reviews
Systematic reviews published 1996-1998 containing clinical trials on conservative management strategies for neck pain.
(N=25 unique reviews)Conservative treatment for neck pain, including manual therapies, physical medicine modalities, drug treatment and education.Outcomes: Efficacy of interventions rated as benefit, inconclusive or no benefit. Methodological quality of review scored on 18 point scale.
Follow-up: Variable. Reviews consistent that evidence for manipulation, traction, immobilization, laser therapies is inconclusive; reviews inconsistent about evidence regarding mobilization and acupuncture. Of the five reviews addressing electromagnetic therapy, four found benefit. Limitations include heterogeneity in study populations and type of neck pain addressed, which may impact on expectations for consistency amongst studies and reviews.
Hurwitz et al. (1996) ADDIN REFMGR.CITE Hurwitz19961580Manipulation and mobilization of the cervical spine. A systematic review of the literature.Journal1580Manipulation and mobilization of the cervical spine. A systematic review of the literature.Hurwitz,E.Aker,P.D.Adams,A.H.Meeker,W.C.Shekelle,P.G.1996/8/1*Cervical Vertebrae*Headacheth [Therapy]*Manipulation,Orthopedicmt [Methods]*Neck Painth [Therapy]AnalysisArticleBackBack Paincervicalcervical spineComplicationsData BaseHeadacheHumanLow Back PainManipulation,Orthopedicae [Adverse Effects]manual therapyMeta-AnalysisMethodsNeckNeck PainPainPatientsRandomized Controlled TrialRandomized Controlled TrialsResearchReviewspinal manipulationSpineSupport,Non-U.S.Gov'tSupport,U.S.Gov't,Non-P.H.S.Systematic ReviewTherapyTreatment OutcomeNot in File17461759Spine2115Scientifically AdmissibleSystematic ReviewIntervention279Spine116
Systematic review
All intervention studies regarding efficacy and complications of cervical spinal manipulation and mobilization for acute and subacute/chronic neck pain. Identified by Medline, Embase, Chirolars, Cinahl from 1966 (or earliest available) to 1995.
(N=42 primary studies on cervical manual therapy for neck pain and 118 on complications; 9 studies were RCTs)Cervical manipulation and cervical mobilization. Variable comparison groups.Outcomes: Pain intensity, functional status, cervical range of motion, return to work.
Follow-up: Immediate to 6 months.Short-term benefit for cervical mobilization for acute neck pain. Greater short-term pain relief for cervical manipulation in subacute/chronic neck pain (compared with mobilization or physical therapy, muscle relaxants or usual medical care). Complication rate for cervical spine manipulation estimated at 5-10 per 10 million manipulations. Major Limitations: No details provided about non-RCT intervention studies.
Karjalainen et al. (2001) ADDIN REFMGR.CITE Karjalainen20011529Multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults.Journal1529Multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults.Karjalainen,K.Malmivaara,A.van Tulder,M.Roine,R.Jauhiainen,M.Hurri,H.Koes,B.2001AdultAgeAnalysisClinical TrialClinical TrialsData CollectionDatabasesDisabilityFinlandHealthNeckOccupational HealthPainPatientsRandomized Controlled TrialRandomized Controlled TrialsRCTRehabilitationReviewScienceShoulderShoulder PainStressSystematic ReviewWorkNot in File174181Spine262Y (The list was sent in November 2002)Scientifically admissibleReviewIntervention52MedlineFinnish Institute of Occupational Health, Topeliuksenkatu 41 aA, Helsinki, Finland. Kaija.Karjalainen@occuphealth.fiSpine117
Systematic review (Cochrane Collaboration)
Clinical trials published up to 1998 assessing multidisciplinary rehabilitation for chronic non-specific neck and shoulder pain in adults. Excludes acute trauma, neoplasms, inflammatory or neurological disease, postoperative pain and osteoporosis.
(N=2 studies, with 82 intervention subjects and 77 comparison subjects)Multidisciplinary treatment consisting of a physician consultation and one or more of psychological, social or vocational intervention. Comparison groups were traditional treatment.Outcomes: Pain intensity, functional status, time on sick leave, mood.
Follow-up: 6 months to 2 years.Two relevant studies were identified. Little evidence for multidisciplinary treatment. Limited support for the role of a psychologist as an advisor to other health care professionals.
Conclusions limited by lack of studies, use of scoring system to produce numerical scores for methodological quality has not been well validated.
Kay et al. (2006) ADDIN REFMGR.CITE Kay2005720Exercises for mechanical neck disordersJournal720Exercises for mechanical neck disordersKay,T.M.Gross,A.Goldsmith,C.Santaguida,P.L.Hoving,J.Bronfort,G.Cervical Overview Group2005*Neck Painth [Therapy]*Physical Therapy Modalities*Spondylarthritisth [Therapy]*Whiplash Injuriesth [Therapy]AdultAnalysisArticleCanadacervicalComplianceData CollectionDatabasesDisabilityExerciseExercise TherapyEyeHeadacheHealthHumansLanguageManipulation,ChiropracticMEDLINEMotionNeckNeck disordersNeck PainPainPatient SatisfactionPhysiotherapyProprioceptionRandomized Controlled TrialsRestReviewRiskScienceSystematic ReviewTherapywhiplashWomenNot in FileCochrane Database of Systematic Reviews3CD004250R-RScientifically AdmissibleReview/Systematic Review/Meta-AnalysisIntervention1689MedlineCochrane Database of Systematic Reviews118
Systematic review (Cochrane Collaboration)
Systematic review of RCTs or quasi-RCTs of exercise therapy for adults with mechanical neck disorders with or without headache or radicular findings identified through March 2004 from CENTRAL, Medline, Embase, Mantis, Cinahl, and ICL in any language.
(N=31 studies)
Exercise therapy including specific neck exercises, active exercise, stretching, strengthening, postural, functional, eye-fixation, and proprioception exercises prescribed for neck pain alone or in combination with physical modalities but not as part of a multidisciplinary treatment or requiring application by trained individual.
Outcomes: Pain, function/disability, patient satisfaction, and global perceived effect.
Follow-up: Variable.Limited evidence for (1) strengthening, stretching and strengthening or eye-fixation exercises for neck disorder with headache, (2) active range of motion exercises or a home exercise program for acute neck disorder including WAD, and (3) eye-fixation program for chronic neck disorder in the short term; unclear evidence for stretching and strengthening program for chronic neck disorder; and strong evidence favoring exercise in combination with manipulation or mobilization for subacute and chronic neck disorder with or without headache in short and long term.
Koes et al. (1991) ADDIN REFMGR.CITE Koes19911980Spinal manipulation and mobilisation for back and neck pain: a blinded reviewJournal1980Spinal manipulation and mobilisation for back and neck pain: a blinded reviewKoes,B.W.Assendelft,W.J.van der Heijden,G.J.Bouter,L.M.Knipschild,P.G.1991/11/23Acute DiseaseAnalysisArticleAttentionBackBack PainChiropracticClinical TrialClinical TrialsDouble-Blind MethodEpidemiologyHumanManipulation,OrthopedicMeta-AnalysisMethodsNeckNeck PainNetherlandsPainPatientsPopulationRandomized Controlled TrialsReviewSpinal Diseasesspinal manipulationSupport,Non-U.S.Gov't.TherapyUniversitiesNot in File12981303BMJ3036813R-IScientifically AdmissibleReview/Systematic Review/Meta-AnalysisIntervention1038MedlineDepartment of Epidemiology and Biostatistics, University of Limburg, Maastricht, The NetherlandsBMJ119
Blinded review
RCTs of spinal manipulation (includes manipulation and mobilization) for back or neck pain identified from searching Medline (1966 through 1990); acute and chronic neck pain and whiplash included.
(N=35 studies [5 neck-related; 245 subjects])
Spinal manipulation and mobilization for back or neck pain; comparators in neck trials included diazepam, TENS, collar, analgesics, rest, sham manual therapy, and cervical collar.Outcomes: Pain, perception of improvement.
Follow-up: Immediate to 8 weeks.No convincing evidence that spinal manipulation is more effective than other therapies for acute or chronic neck pain; possibility that manipulation may be effective in certain subgroups.Kroeling et al. (2005, 2006) ADDIN REFMGR.CITE Kroeling20051474Electrotherapy for neck disordersJournal1474Electrotherapy for neck disordersKroeling,P.Gross,A.Houghton,P.E.Cervical Overview Group2005*Electric Stimulation Therapymt [Methods]*Musculoskeletal Diseasesth [Therapy]AdultAnalysisArticleClinical TrialClinical TrialsData CollectionDatabasesGermanyHeadacheHumansLanguageMedicineMEDLINEMeta-AnalysisNeckNeck disordersNeck Painth [Therapy]PainPatient SatisfactionPhysical MedicinePhysiotherapyRandomized Controlled TrialsRehabilitationReviewRiskwhiplashWhiplash Injuriesth [Therapy]Not in FileCochrane Database of Systematic Reviews2CD004251R-RScientifically AdmissibleReview/Sytematic Review/Meta-AnalysisIntervention1660MedlineCochrane Database of Systematic Reviews1Kroeling200512A Cochrane review of electrotherapy for mechanical neck disordersJournal12A Cochrane review of electrotherapy for mechanical neck disordersKroeling,P.Gross,A.R.Goldsmith,C.H.Cervical Overview Group2005/11/1*Electric Stimulation Therapymt [Methods]*Musculoskeletal Diseasesth [Therapy]*Randomized Controlled TrialsAdolescentAdultArticleDatabasesDatabases,BibliographicGermanyGov'tHeadacheHumanslong-term effectsMethodsMusculoskeletal Diseasesco [Complications]NeckNeck disordersNeck Painet [Etiology]Neck Painth [Therapy]Neckpp [Physiopathology]PainPhysiotherapyResearchReviewRiskSpineSystematic ReviewTherapyUnited StateswhiplashWhiplash Injuriesco [Complications]Whiplash Injuriesth [Therapy]Not in FileE641E648Spine20Scientifically AdmissibleReview/Systmatic Review/Meta-AnalysisIntervention1660Spine120;21
Systematic review (Cochrane Collaboration)
RCTs and quasi-randomized trials of electrotherapy for mechanical neck disorders identified from the following databases from their beginning through March 2003: CENTRAL, Medline, Embase, Mantis, Cinahl, and the Index to Chiropractic Literature (ICL); adults 18 years or older with acute (<30 days), subacute (30-90 days), or chronic (>90 days) neck disorders including whiplash-associated disorders, myofascial neck pain, and degenerative changes, neck disorder with headache or with radicular findings.
(N=13 articles, 11 studies [3 WAD]; 525 subjects)
Electrotherapeutic methods including the following either alone or in combination as part of a multimodal treatment: galvanic current, galvanic stimulation, iontophoresis, electrical nerve stimulation, transcutaneous electrical nerve stimulation, electrical muscle stimulation, pulsed electromagnetic field therapy, and static magnetic field (magnetic necklace).Outcomes: Pain relief, disability/function, patient satisfaction, and global perceived effect.
Follow-up: Immediate to 1 year.Limited evidence in favor of pulsed electromagnetic field therapy for immediate post-treatment pain relief in whiplash and chronic mechanical neck disorders; unclear, conflicting, or no evidence for effectiveness of other electrotherapies on pain and other outcomes in short or long term for patients with acute, subacute, or chronic mechanical neck disorders; no side effects reported; no definitive conclusions.Mior (2001a) ADDIN REFMGR.CITE Mior2001179Exercise in the treatment of chronic painJournal179Exercise in the treatment of chronic painMior,S.2001/12*Exercise Therapy*Painth [Therapy]*Palliative Caremt [Methods]ArmBackBack PainChiropracticChronic DiseaseChronic PainExerciseExtremitiesFibromyalgiaFibromyalgiath [Therapy]HumanLow Back PainLow Back Painth [Therapy]NeckNeck PainOntarioPainRandomized Controlled TrialRandomized Controlled TrialsResearchReviewShoulderSyndromeSystematic ReviewUpper ExtremityNot in FileSuppl85Clinical Journal of Pain174:SupplR-R1237MedlineClinical Journal of Pain122
Systematic review
Systematic review of RCTs and systematic reviews of exercise in the management of chronic (>6 months) musculoskeletal pain in adults 18 to 65 years old identified from Medline (1966 - Aug 31, 1998), Embase (1980 - Aug 31, 1998), Cinahl (1982 - Aug 31, 1998), Health Star (1975 - Aug 31, 1998), Psychinfo (to Aug 31, 1998), Dissertation Abstracts International (1861- Aug 31, 1998), Cochrane Library (3: 1998), Pain Relief Database (1950 1994).
(N=10 total; 1 systematic review and 1 RCT pertaining to neck pain)
Exercise interventions for chronic musculoskeletal pain.Outcomes: Pain, function, work disability, non-work disability, quality of life, and global outcome.
Follow-up: 2 weeks to 1 year.Limited evidence that exercise is effective for chronic neck pain in the short to intermediate term.Mior (2001b) ADDIN REFMGR.CITE Mior2001180Manipulation and mobilization in the treatment of chronic pain.Journal180Manipulation and mobilization in the treatment of chronic pain.Mior,S.2001/12*Movement*Musculoskeletal Manipulations*Painth [Therapy]*Palliative Caremt [Methods]BackBack PainChiropracticChronic DiseaseChronic PainEarly AmbulationHeadacheHumanLow Back PainNeckNeck PainOntarioPainPlacebosRandomized Controlled TrialRandomized Controlled TrialsResearchReviewShoulderSystematic ReviewNot in FileSuppl6Clinical Journal of Pain174:SupplR-R (Review with 179)1238MedlineClinical Journal of Pain123
Systematic review
Systematic review of RCTs and systematic reviews of manipulation and mobilization in the management of chronic (>6 months) pain in adults 18 to 65 years old identified from Medline (1966 - Aug 31, 1998), Embase (1980 - Aug 31, 1998), Cinahl (1982 - Aug 31, 1998), Health Star (1975 - Aug 31, 1998), Psychinfo (to Aug 31, 1998), Dissertation Abstracts International (1861- Aug 31, 1998), Cochrane Library (3: 1998), Pain Relief Database (1950 1994).
(N=10 total; 2 systematic reviews and 3 RCTs pertaining to neck pain or post-traumatic headache)
Manipulation and mobilization for chronic pain.Outcomes: Pain, function, work disability, non-work disability, quality of life, and global outcome.
Follow-up: Immediate to 12 weeks.
Inconsistent evidence that manipulation or mobilization is as effective as other conservative treatments for chronic neck pain in the short to intermediate term; limited evidence that manipulation is effective for chronic post-traumatic headache in the short term.
Peloso et al. (2006a, 2006b) ADDIN REFMGR.CITE Peloso20051475Medicinal and injection therapies for mechanical neck disordersJournal1475Medicinal and injection therapies for mechanical neck disordersPeloso,P.Gross,A.Haines,T.Trinh,K.Goldsmith,C.H.Aker,P.Cervical Overview Group2005*Anesthetics,Localad [Administration & Dosage]*Anti-Inflammatory Agents,Non-Steroidalad [Administration & Dosage]*Neck Paindt [Drug Therapy]*Psychotropic Drugsad [Administration & Dosage]*Whiplash Injuriesdt [Drug Therapy]0 (Anesthetics,Local)0 (Anti-Inflammatory Agents,Non-Steroidal)0 (Psychotropic Drugs)137-58-6 (Lidocaine)83-43-2 (Methylprednisolone)AdultAnalysisArticleChronic DiseaseConsensusData CollectionDiazepamDisabilityFollow Upfollow-upHeadacheHumansInjectionsLidocaineLidocainead [Administration & Dosage]MedicineMEDLINEMeta-AnalysisMethylprednisoloneMethylprednisolonead [Administration & Dosage]MotionNeckNeck disordersNeck PainNerve BlockPainPatient SatisfactionRandomized Controlled TrialRandomized Controlled TrialsReviewSick LeaveTherapywhiplashNot in FileCochrane Database of Systematic Reviews2CD000319R-R1598MedlineCochrane Database of Systematic Reviews1Peloso20066795Medicinal and injection therapies for mechanical neck disorders: a Cochrane systematic reviewJournal6795Medicinal and injection therapies for mechanical neck disorders: a Cochrane systematic reviewPeloso,P.M.Gross,A.Haines,T.A.Trinh,K.Goldsmith,C.H.Aker,P.2006NeckNeck disordersReviewSystematic ReviewTherapyNot in File957967Journal of Rheumatology33Journal of Rheumatology124;25
Systematic review (Cochrane Collaboration)
RCTs of medicines and injections used to improve pain, function/disability, and patient satisfaction in adults with mechanical neck disorders with or without headache or radicular findings identified by searching CENTRAL (Issue 4, 2002) and Medline, Embase, Mantis, Cinahl (start dates through March 2003).
(N=32 studies)Medicinal and injection therapies for mechanical neck disorders: anesthetics, nonsteroidal anti-inflammatory drugs, muscle relaxants, opioids, corticosteroids, and botulinum toxin A (Botox A).Outcomes: Pain improvement, tenderness and threshold, function, disability, work status, cervical range of motion, global perceived effect, and patient satisfaction.
Follow-up: Less than 1 week to 6 months.Evidence for short-term effectiveness of intravenous methylprednisolone injection for acute whiplash and for intramuscular lidocaine injection for chronic mechanical neck disorders; limited evidence for epidural methylprednisolone and lidocaine injection for chronic mechanical neck disorders with radicular findings; conflicting evidence for oral psychotropic agents and evidence against effectiveness of botulinum toxin for chronic disorders.
Sarig-Bahat (2003) ADDIN REFMGR.CITE Sarig-Bahat20032022Evidence for exercise therapy in mechanical neck disordersJournal2022Evidence for exercise therapy in mechanical neck disordersSarig-Bahat,H.2003/2*Exercise Therapy*Neck Painth [Therapy]AdultChronic DiseasediscogenicExerciseExercise TherapyExercise Therapymt [Methods]HumanIsraelMethodsNeckNeck disordersNeck Painpc [Prevention & Control]Neck Painpp [Physiopathology]PatientsPhysical TherapyPhysical Therapy Techniquesmt [Methods]PopulationRandomized Controlled TrialRandomized Controlled TrialsRange of Motion,ArticularRCTReviewSchoolsSystematic ReviewTherapyTreatment OutcomeUniversitieswhiplashNot in File1020Manual Therapy81R-RScientifically AdmissibleReview/Systematic Review/Meta-AnalysisIntervention1158MedlineManual Therapy126
Systematic review
Systematic review of RCTs and other comparative studies of exercise therapy for mechanical neck disorders (WAD grades I and II), whiplash associated or chronic-recurrent, identified from Amed, Cinahl, Embase, SportsDiscus, and PEDro and published in English or Hebrew between Jan. 1985 and Oct. 2001.
(N=16 studies [4 WAD], all randomized; 1323 subjects)
Active exercise interventions including stretching, strengthening, endurance or aerobic training, postural correction, neuromuscular control and movement awareness; passive therapies and exercise in combination with passive therapies excluded. Various active and passive comparison groups; 9 trials included no-treatment controls.Outcomes: Cervical range of motion, pain, disability, coping, self-efficacy, global assessment, trigger points, muscle strength and endurance, muscle activity, pressure pain threshold, medication and health care use, satisfaction, and sick leave.
Follow-up: 10 weeks to 12 months.Strong evidence in support of proprioceptive and dynamic resisted strengthening exercises for chronic or recurrent neck pain; moderate evidence for early mobilizing exercises for acute whiplash; no support for group exercise, neck schools, or single extension-retraction exercise sessions.Spitzer et al. (1995) ADDIN REFMGR.CITE Spitzer19951004Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining "whiplash" and its managementJournal1004Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining "whiplash" and its managementSpitzer,W.O.Skovron,M.L.Salmi,L.R.Cassidy,J.D.Duranceau,J.Suissa,S.Zeiss,E.1995/4/15Accidents,TrafficArticleCanadaClassificationDiagnosisEconomicsEpidemiologyEtiologyFemaleHumanIncidenceMalePractice GuidelinesPrognosisQuebecResearchReviewSpineTherapyUniversitiesWhiplash InjuriesWhiplash Injuries.Not in File1S73SSpine208Y (The list was sent in November 2002)Scientifically admissibleGuidelinesDiagnosis + Prognosis + Primary Prevention/Risk + Intervention42MedlineDepartment of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, CanadaSpine127
Systematic review
(Best Evidence Synthesis)
Studies identified from Medline, TRIS, NTIS 1980-1993 containing subjects with whiplash injuries.
(N=17 of 65 studies on treatment accepted; 10 separate RCTs)Soft collars, rest, cervical pillows, cervical manipulation, cervical mobilization, exercise, traction, postural alignment, Pulsed electromagnetic treatment, steroid injections, subcutaneous sterile water trigger point injections, analgesics, prescribed function, acupuncture, magnetic necklace.Outcomes: Pain intensity, functional status, cervical range of motion, return to work.
Follow-up: VariableSoft collars, rest may delay recovery. Limited role for prescription drugs. Limited use of manipulation; physical therapy may be useful to facilitate early mobility; surgery is rarely indicated. No scientifically sound evidence for other treatments; conclusions limited by lack of methodologically sound studies.
Trinh et al. (2007) ADDIN REFMGR.CITE Trinh20076680Acupuncture for neck disorders.Journal6680Acupuncture for neck disorders.Trinh,K.Graham,N.Gross,A.Goldsmith,C.Wang,E.Cameron,I.Kay,T.2007/1/15*Acupuncture Therapy*Neck Painth [Therapy]AcupunctureArticleCanadaChinaChronic DiseaseClinical TrialsFollow Upfollow-upGov'tHealthHumansMassageMedicineMEDLINEMethodsMusculoskeletal SystemNeckNeck disordersNeck PainNursingOntarioPainPerceptionRCTResearchReviewSpineSystematic ReviewTreatment OutcomeUnited StatesUniversitiesNot in File236243Spine322Spine128
Systematic review (Cochrane Collaboration)
Systematic review of RCTs and quasi-RCTs of acupuncture for acute, subacute, or chronic neck pain identified from Central (2006, issue 1) and from Medline, Embase, Mantis, and Cinahl from initiation through Feb. 2006, and from reference lists and Chinese acupuncture database TCMLARS.
(N=10 studies [chronic neck pain only])
Acupuncture for acute, subacute, or chronic neck pain with or without radicular symptoms.Outcomes: Pain relief.
Follow-up: Immediate post-treatment to 6 months.Overall methodological quality 2.3/5 on Jadad scale. Moderate evidence that acupuncture is (1) more effective than some sham interventions immediate post-treatment and at short-term follow-up for chronic neck pain, and (2) more effective than wait-list controls in the short-term for patients with radicular symptoms; limited evidence that acupuncture is more effective than massage in the short term.Van der Heijden et al. (1995) ADDIN REFMGR.CITE van der Heijden19951620The efficacy of traction for back and neck pain: a systematic, blinded review of randomized clinical trial methodsJournal1620The efficacy of traction for back and neck pain: a systematic, blinded review of randomized clinical trial methodsvan der Heijden,G.J.Beurskens,A.J.Koes,B.W.Assendelft,W.J.de Vet,H.C.Bouter,L.M.1995/2*Back Painth [Therapy]*Neck*Painth [Therapy]*Randomized Controlled Trials*TractionAnalysisArticleAttentionBackBack PainBias (Epidemiology)Clinical TrialClinical TrialsComparative StudyConfidence IntervalsEpidemiologyHumanMethodsNeckNeck PainNetherlandsPainPatientsPopulationrandomized clinical trialReproducibility of ResultsResearch DesignReviewSingle-Blind MethodSupport,Non-U.S.Gov'tTherapyTractionTreatment OutcomeUniversitiesNot in File93104Physical Therapy752Scientifically AdmissibleSystematic ReviewIntervention334Physical Therapy129
Systematic review
Systematic review of all RCTs of efficacy of traction for neck pain, and where clinically relevant outcome measures were used.
(N=3 studies on cervical traction; N=215 subjects for interventions and 424 in comparison groups)
Intermittent motorized traction, continuous motorized traction and manual traction. Comparison groups included exercise, sham traction, no intervention, detuned ultrashort waves, analgesics, hot packs neck school, and mobilizing.
Outcomes: Patient and clinician global estimate of improvement.
Follow-up: 3 to 6 weeks after treatment.No strong, valid judgment can be made about efficacy of cervical traction due to poor methodological quality.Verhagen et al. (2005) ADDIN REFMGR.CITE Verhagen20042086Conservative treatments for whiplashJournal2086Conservative treatments for whiplashVerhagen,A.P.Scholten-Peeters,G.G.de Bie,R.A.Bierma-Zeinstra,S.M.2004*Whiplash Injuriesth [Therapy]AnalysisChronic DiseaseClinical TrialData Collectiongeneral practiceHumansMEDLINENeckNetherlandsPainPatientsPopulationRandomized Controlled TrialsRestReviewSystematic ReviewTherapyUniversitieswhiplashNot in FileCochrane Database of Systematic Reviews1CD003338R-RScientifically AdmissibleReview/Systematic Review/Meta-analysisIntervention1359Cochrane Database of Systematic Reviews130
Systematic review (Cochrane Collaboration)
Systematic review of all English, French, German, and Dutch RCTs of the efficacy of non-invasive, non-surgical, non-drug interventions for WAD Grade 1 or 2 injuries that included pain, global perceived effect or participation in daily activities as outcome measures and identified from the following databases from their beginning to April 2003 and searched according to the strategy recommended by the Editorial Board of the Cochrane Back Review Group: Cochrane Central Register of Controlled Trials, Medline, Cinahl, Embase, PsycLIT, and the database of the Dutch Institute of Allied Health Professions.
(N=16 articles; 15 studies and 1549 subjects)
Conservative interventions defined as any non-invasive, non-surgical, non-drug treatment for WAD Grade 1 or 2 (i.e., neck complaints with or without musculoskeletal signs); passive intervention defined as without exercise or activities performed by the patient.Outcomes: Pain, global perceived effect, participation in daily activities; 15% or greater improvement relative to a control defined as clinically relevant.
Follow-up: 2 weeks to 6 months.Overall poor quality and heterogeneity of studies. Limited evidence that both passive and active interventions are more effective than no treatment; conflicting evidence that active treatments are more effective than passive ones; no clear conclusion can be drawn about effectiveness of interventions for patients with symptoms lasting longer than 6 months.Vernon et al. (1999) ADDIN REFMGR.CITE Vernon1999507Systematic review of randomized clinical trials of complementary/alternative therapies in the treatment of tension-type and cervicogenic headache.Journal507Systematic review of randomized clinical trials of complementary/alternative therapies in the treatment of tension-type and cervicogenic headache.Vernon,H.McDermaid,C.S.Hagino,C.1999/9AcupunctureAcupuncture TherapyAlternative MedicineArticleCanadaCervical VertebraeChiropracticChronic DiseaseClinical TrialClinical TrialsConfidence IntervalsDiagnosisFemaleFollow-Up StudiesGov'tHeadacheHealth SurveysHomeopathyHumanMaleManipulation,SpinalMethodsMigrainePain MeasurementPhysical TherapyPhysiopathologyPhysiotherapyrandomized clinical trialRandomized Controlled TrialsRCTReviewReview Literaturespinal manipulationSupport,Non-U.SSystematic ReviewTension HeadacheTherapyTreatment Outcome.Not in File142155Complementary Therapies in Medicine73R-RScientifically AdmissbleReview/Systematic Review/Meta-AnalysisIntervention1376MedlineCanadian Memorial Chiropractic College, Toronto, CanadaComplementary Therapies in Medicine131
Systematic review
Systematic review of all RCTs of adult non-migrainous headache (e.g., tension-type, cervicogenic) sufferers randomized to complementary/alternative therapies, including acupuncture, chiropractic, physiotherapy, massage, homeopathy, and others, identified from Medline (1966 to mid-1998), PsychInfo, and Cinahl, or from reference lists of identified studies or from author queries.
(N=24 studies; N=264 subjects for acupuncture, 286 for spinal manipulation, 507 for electrotherapy, and 147 for physiotherapy)
Complementary/alternative therapies, including acupuncture, spinal manipulation, electrotherapy, multimodal physiotherapy, massage, homeopathy, analgesic/counter-irritant ointment (Tiger Balm), and therapeutic touch.Outcomes: Headache intensity and frequency, pain relief, mood state, overall health function.
Follow-up: Immediate to 3 years.Electrotherapy to cranial muscles may be beneficial and homeopathy likely not beneficial for tension-type headache; because of insufficient or contradictory evidence, no conclusions may be drawn regarding the effectiveness of other complementary or alternative therapies for non-migrainous headache.White et al. (1999) ADDIN REFMGR.CITE White19991333A systematic review of randomized controlled trials of acupuncture for neck pain.Journal1333A systematic review of randomized controlled trials of acupuncture for neck pain.White,A.R.Ernst,E.1999/2AcupunctureAcupuncture AnalgesiaArticleClinical TrialClinical TrialsComparative StudyHealthHumanInstrumentationLasersMedicineMethodsNeckNeck PainNeedlesPainPhysiotherapyRandomized Controlled TrialRandomized Controlled TrialsReviewScienceSoundSupport,Non-U.S.Gov't.Systematic ReviewTherapyUniversitiesNot in File143147Rheumatology (Oxford)382R-RScientifically AdmissibleSystematic ReviewIntervention688MedlineDepartment of Complementary Medicine, School of Postgraduate Medicine and Health Sciences, University of Exeter, UKRheumatology (Oxford)132
Systematic review
Systematic review of all randomized controlled trials of acupuncture for neck pain. Medline 1966-1997; Embase 1974-1997; Cochrane Library, 1988, CISCOM (1977); needle acupuncture, electroacupuncture or laser acupuncture compared with a non-acupuncture control group.
(N=14 studies)
Needle, electro- or laser acupuncture. Comparison groups included sham acupuncture, waiting list, sham tens, superficial acupuncture, diazepam and placebo diazepam, physical therapy.Outcomes: Pain intensity and cervical range of motion.
Follow-up: Immediate to 6 months.Findings were inconsistent and five of the eight high quality trials were negative.
ADDIN REFMGR.REFLIST Reference List
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2. Bronfort G, Assendelft WJ, Evans R et al. Efficacy of spinal manipulation for chronic headache: a systematic review. Journal of Manipulative & Physiological Therapeutics 2001;24:457-66.
3. Bronfort G, Haas M, Evans RL et al. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine 2004;4:335-56.
4. Carlsson J, Norlander S, Rundcranz B et al. Evidence based physiotherapy: Patients with neck disorders. 101. 1999. Ref Type: Report
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9. Geurts JW, van Wijk RM, Stolker RJ et al. Efficacy of radiofrequency procedures for the treatment of spinal pain: a systematic review of randomized clinical trials. Regional Anesthesia & Pain Medicine 2001;26:394-400.
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11. Gross AR, Hoving JL, Haines TA et al. A Cochrane review of manipulation and mobilization for mechanical neck disorders. Spine 2004;29:1541-8.
12. Gross AR, Hoving JL, Haines TA et al. Manipulation and mobilisation for mechanical neck disorders. Cochrane Database of Systematic Reviews 2004;1.
13. Gross AR, Kay T, Hondras M et al. Manual therapy for mechanical neck disorders: a systematic review. Manual Therapy 2002;7:131-49.
14. Haraldsson BG, Gross AR, Myers CD et al. Massage for mechanical neck disorders. Cochrane Database of Systematic Reviews 2006;3.
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24. Peloso P, Gross A, Haines T et al. Medicinal and injection therapies for mechanical neck disorders. Cochrane Database of Systematic Reviews 2005;2.
25. Peloso PM, Gross A, Haines TA et al. Medicinal and injection therapies for mechanical neck disorders: a Cochrane systematic review. Journal of Rheumatology 2006;33:957-67.
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32. White AR, Ernst E. A systematic review of randomized controlled trials of acupuncture for neck pain. Rheumatology (Oxford) 1999;38:143-7.
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