Non-specific neck pain: diagnosis and treatment - KCE
Non-specific neck pain: diagnosis and treatment - KCE
Non-specific neck pain: diagnosis and treatment - KCE
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ii non-<strong>specific</strong> <strong>neck</strong> <strong>pain</strong> <strong>KCE</strong> reports 119C<br />
INTRODUCTION<br />
Executive summary<br />
This study aims to provide a systematic review of the scientific literature on <strong>diagnosis</strong>,<br />
prognosis <strong>and</strong> <strong>treatment</strong> of acute <strong>and</strong> chronic non-<strong>specific</strong> <strong>neck</strong> <strong>pain</strong>. The objective is to<br />
propose evidence-based key messages to diagnose <strong>and</strong> to treat adults who suffer from<br />
non-<strong>specific</strong> <strong>neck</strong> <strong>pain</strong>.<br />
Neck <strong>pain</strong> is a wide entity which includes e.g. non-<strong>specific</strong> <strong>neck</strong> <strong>pain</strong> <strong>and</strong> <strong>neck</strong> <strong>pain</strong><br />
associated disorders. Symptoms vary with physical activity <strong>and</strong> over time. Each form of<br />
acute, subacute or chronic <strong>neck</strong> <strong>pain</strong>, where no abnormal anatomic structure as cause<br />
of <strong>pain</strong> can be identified, is non-<strong>specific</strong> <strong>neck</strong> <strong>pain</strong>. In the literature, no generally<br />
accepted definition exists for the concept acute, sub-acute or chronic.<br />
METHODOLOGY<br />
The literature search covered the period from 1998 to 2008 <strong>and</strong> included (systematic)<br />
reviews, meta-analyses, guidelines, RCTs <strong>and</strong> clinical trials.<br />
The researchers screened the scientific literature in Medline, Embase, Cochrane <strong>and</strong><br />
Pedro databases. Moreover, existing guidelines were searched in <strong>specific</strong> databases. All<br />
papers were screened by a team of two reviewers. A multidisciplinary panel of experts<br />
joined the research team to define the evidence level of the conclusions using the<br />
“GRADE” system:<br />
• Grade A (high level of evidence): RCTs without important limitations or<br />
overwhelming evidence from observational studies;<br />
• Grade B (moderate level of evidence): RCTs with important limitations<br />
(inconsistent indirect, or imprecise results; methodological flaws) or<br />
exceptionally strong evidence from observational studies;<br />
• Grade C (low level of evidence): Lower level of evidence.<br />
Finally, the conclusions of this review were compared to those of two high quality<br />
guidelines identified during the search.