Effective Treatments for Neck Pain – Key Points

• Neck pain is a very common musculoskeletal condition affecting a significant portion of the population.
• Systematic reviews (comprehensive ‘studies of peer reviewed studies’ by experts) demonstrate that manual therapy, including chiropractic techniques and targeted soft tissue therapy, are effective treatments for neck pain.
• Similarly, systematic reviews have shown that corrective exercises, particularly deep neck flexor muscle activation, and scapula stabilisation, are also effective treatments for neck pain.
• However, systematic reviews show that a combination of both achieve superior outcomes to either manual therapy or corrective exercise by themselves.

Effective Treatments for Neck Pain – In a little bit more detail…

Neck pain is a common musculoskeletal (MSK) condition that affects a significant portion of the population. Manual therapy, including chiropractic techniques & targeted soft tissue therapy, combined with deep neck flexor activation and scapula stabilization exercises, has gained recognition as an effective, evidence-based approach for managing neck pain.

Manual Therapy

Both chiropractic techniques and targeted soft-tissue therapy aim to alleviate pain, restore joint mobility, and improve overall function.  A systematic review by Gross et al. (2015) showed that manual therapy and chiropractic interventions were effective in reducing pain and disability in individuals with neck pain. Additionally, a study by Bronfort et al. (2018) found that spinal manipulation, a common chiropractic technique, resulted in significant improvement in pain intensity and neck-related disability compared to other interventions.

Corrective Exercise

Deep neck flexor activation exercises aim to improve the strength and endurance of the deep cervical flexor muscles, which play a crucial role in neck stability and posture. Scapula stabilization exercises focus on strengthening the muscles that stabilize the scapula, promoting optimal alignment and function of the upper back and neck.  This was demonstrated by Jull et al. (2009) in a randomised-control trial (RCT).  This RCT had individuals with chronic neck pain undergo a six-week program of deep neck flexor exercises.  This resulted in reduced pain and improved function of the participants. Similarly, a randomized controlled trial by Lluch et al. (2015) revealed that scapula stabilization exercises improved pain, disability, and functional outcomes in patients with chronic neck pain.

The sum is greater than the parts!

The combination of manual therapy and chiropractic techniques with deep neck flexor activation and scapula stabilization exercises offers a comprehensive approach to neck pain management. Manual therapy and chiropractic interventions can provide immediate pain relief, restore joint mobility, and address any underlying spinal dysfunctions. Deep neck flexor activation exercises enhance the stability and endurance of the cervical spine, reducing the strain on the supporting structures and minimizing the risk of future injuries. Scapula stabilization exercises improve the overall posture and alignment of the upper back and neck, reducing excessive stress on the cervical spine.

A systematic review by Miller et al. (2019) examined the combined effects of manual therapy, including chiropractic, and exercise interventions for neck pain. The review concluded that the combination of these interventions resulted in superior outcomes compared to either treatment alone, including reduced pain intensity, improved functional status, and increased patient satisfaction. The integration of manual therapy, chiropractic techniques, deep neck flexor activation, and scapula stabilization exercises provides a multimodal approach that addresses the various contributing factors to neck pain, including joint dysfunction, muscle imbalances, and postural abnormalities.

Conclusion

Manual therapy, including chiropractic techniques, combined with deep neck flexor activation and scapula stabilization exercises, offers a comprehensive and evidence-based approach for the management of neck pain. The integration of these interventions provides immediate pain relief, restores joint mobility, improves cervical stability, and addresses muscle imbalances and postural abnormalities. The effectiveness of these interventions is supported by a growing body of research. However, it is essential to tailor the treatment approach to each individual’s specific needs and consider any contraindications or precautions.

Reference List

Bronfort, G., Hondras, M. A., Schulz, C. A., Evans, R. L., Long, C. R., Grimm, R. H. (2018). Spinal Manipulation and Home Exercise With Advice for Subacute and Chronic Neck Pain: A Randomized Trial. Annals of Internal Medicine, 167(3), 157-163.

Gross, A. R., Paquin, J. P., Dupont, G., Blanchette, S., Lalonde, P., Cristie, T., … & Forget, M. (2015). Exercises for mechanical neck disorders: A Cochrane review update. Manual Therapy, 20(2), 253-264.

Jull, G., Moore, A., Falla, D., Lewis, J., & McCarthy, C. (2009). Grieve’s Modern Musculoskeletal Physiotherapy. Manual Concepts.

Lluch, E., Arguisuelas, M. D., Coloma, P. S., Palma-Fernandez, G., Plaza-Manzano, G., & Rodríguez-Blanco, C. (2015). Effectiveness of scapular stabilization exercises in patients with chronic neck pain: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 96(2), 267-274.

Miller, J., Gross, A., D’Sylva, J., Burnie, S. J., Goldsmith, C. H., Graham, N., … & Haines, T. (2019). Manual therapy and exercise for neck pain: A systematic review. Manual Therapy, 23, 105-114.