Which type of exercise is best for chronic neck pain?
- RRS Education
Approximately 70% of the world’s population experiences at least one episode of neck pain in their lives, with more than half of the cases recurring within 1 to 5 years. This has created a significant burden on society due to lost productivity and increasing spinal pain-related healthcare expenditures.
Clinical guidelines recommend physical exercise (ex. strengthening, range of motion, motor control, stretching and proprioceptive training) as a first-line management strategy in the treatment of neck pain, even though review articles on physical exercise for people with chronic neck pain have reported modest effect sizes on pain intensity and pain-related disability.
It has been difficult to determine the most effective and appropriate neck exercises based on typical randomized controlled trials (RCTs), systematic reviews and meta-analyses because they only allow for pairwise comparisons of two types of exercise and cannot be used to compare the effectiveness of all types of physical exercise. However, a network meta-analysis (NMA) allows an entire body of evidence to be evaluated, even when some interventions have not been directly compared with others in specific trials. NMA also produces a hierarchy of interventions which can provide valuable information for clinical decision-making.
To date, no treatment options have demonstrated medium or large effect sizes on pain and disability in chronic neck pain patients. Therefore, the purpose of this NMA was to systematically investigate the effectiveness of various types of physical exercise in people with chronic non-specific neck pain: 1) primarily, to determine their effectiveness on neck pain intensity and pain-related disability, and 2) secondarily, the effectiveness of different durations, frequencies and intensities of physical exercise interventions on neck pain intensity and pain-related disability.
THIS WEEK'S RESEARCH REVIEW: “Comparative Effectiveness of Physical Exercise Interventions for Chronic Non-Specific Neck Pain”
This paper was published in the> British Journal of Sports Medicine (2021) and this Review is posted in and the 2021 Archive.