The treatment of neck pain is multifactorial. The articular, muscular, and motor control (neural) systems may all or in part be implicated.\u00a0 This triad can be influenced by non-neuromusculoskeletal factors such as the clients’ current emotional and psychosocial well-being.\u00a0As many physiotherapists treat neck pain, it is important to be aware of the most recent and up to date research investigating the efficacy of various physiotherapeutic techniques and interventions in the management of neck pain.\u00a0According to the Manipulative Physiotherapists Association of Australia (MPAA) the following conclusions can be made.<\/p>\n
Manipulative Physiotherapy<\/strong><\/p>\n Appropriate treatment depends on an accurate diagnosis.\u00a0 Manual diagnosis by a trained manipulative physiotherapist can be as accurate as the “Gold standard” radiologically-controlled diagnostic blocks in the diagnosis of cervical “Z” joint syndromes (Jull et al 1988).<\/p>\n Evidence suggests that manual therapy is effective in both the treatment of acute and chronic neck pain.\u00a0 Manipulative therapy is a highly effective treatment approach that involves the application of specific therapies to reduce pain, restore normal movement and prevent future problems.\u00a0 Manipulative therapy consists of passive joint mobilizations (gentle movement of individual joints and surrounding structures), manipulation (controlled quick thrusting techniques to the joint which produces at times an audible clicking or popping sound) and therapeutic exercise.<\/p>\n (Note: Alessandro Rosatelli is a registered manual and manipulative physiotherapist and clinic co-owner of Body in Balance Physiotherapy in Bradford, Ontario<\/em>).<\/p>\n Traction<\/strong><\/p>\n Traction has been shown to separate vertebrae, hence it may be hypothesized that it could give relief from radicular symptoms by decreasing forces on sensitive neural structures. The efficacy of using traction for the treatment of neck pain has not been established.\u00a0 Of five randomized control trials, two had positive and three had negative results.<\/p>\n Exercise<\/strong><\/p>\n There is recent level II evidence which supports the use of specific exercises in the management of neck pain.\u00a0 So far there is no evidence in support of Pilates, Feldenkrais, or Alexander technique.<\/p>\n Collars<\/strong><\/p>\n Level II evidence suggests that cervical collars are not helpful in the treatment of neck pain.\u00a0 Furthermore, available evidence does not support the use of bed rest.<\/p>\n Electrotherapy<\/strong><\/p>\n Evidence is limited.\u00a0 There are a few studies that support the use of TENS, biofeedback, and pulsed electromagnetic therapy.\u00a0 Despite its wide use, there is no support for ultrasound.\u00a0 Laser therapy and infra-red therapy also does not seem to have much support.\u00a0 There is some support for the use of acupuncture (primarily level I & II evidence).<\/p>\n