Common Neck Pain Treatments Questioned

Strengthening, Relaxation Failed to Improve Chronic Neck Pain

From the WebMD Archives

Aug. 28, 2003 --- Two commonly recommended treatments for chronic neck pain are no more effective than no treatment at all, new research shows.

Researchers concluded that the muscle strengthening and relaxation techniques used in the study should not be prescribed for the treatment of chronic neck pain. But an expert contacted by WebMD says physical therapy to strengthen neck muscles works well for many patients.

Stretching and Strengthening

"The first thing we do when someone comes in with neck pain is try to diagnose the cause of the pain," says Henry Goitz, MD, an orthopaedic surgeon. "For most patients treatment will first involve gentle stretching exercises until they get motion back, and then we move on to muscle-strengthening exercises. This treatment is very effective." Goitz is chief of the sports medicine department at the Medical College of Ohio and a spokesman for the American Academy of Orthopaedic Surgeons.

Roughly 70% of adults experience neck pain at some point during their lives. It is a problem that is becoming increasingly common as more and more people spend their workdays sitting in front of computers. A recent study found that people who sit during 95% of their working day are at increased risk for developing chronic neck pain.

Treatment Without Benefit

In the Finnish study, 393 female office workers with chronic neck pain received either three months of muscle-strengthening training, three months of relaxation training, or no treatment. The women taught strength training or relaxation techniques met with physical therapists three times a week in groups of 10.

Although the women who received treatment did show improved neck movement, no significant difference in neck pain was reported one year later between the treatment and non-treatment groups.

"Our study showed that these particular interventions were not effective, but we are not saying that all similar therapies are ineffective," researcher Matti Viljanen, MD, tells WebMD. "It is important that we study this further to see why these treatments did not work. It may be that they were not as intense as they should have been or that training patients in groups of 10 is too much."

Goitz estimates that more than 90% of patients with nonspecific, chronic neck pain can be helped with a treatment regimen that includes stretching and strengthening the neck muscles. He considers relaxation techniques a second-line treatment, but says many patients do respond to them.

"In most cases when patients don't get better [with stretching and strength training] it is because either the therapist isn't doing their job, the patient isn't doing their job, or the doctor missed the diagnosis," he says.

Show Sources

SOURCES: British Medical Journal, Aug. 30, 2003. Matti Viljanen, MD, specialist in rehabilitation medicine, Tampere Regional Institute of Occupational Medicine, Finland. Henry Goitz, MD, chief of the sports medicine department, Medical College of Ohio; spokesman, American Academy of Orthopaedic Surgeons.
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