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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8 Is a multidisciplinary approach<br />
effective for non-<strong>specific</strong> <strong>neck</strong><br />
<strong>KCE</strong> Reports 119 <strong>Non</strong>-Specific Neck Pain: <strong>diagnosis</strong> <strong>and</strong> <strong>treatment</strong> 59<br />
No recommendation could be made<br />
based upon the literature search.<br />
9<br />
<strong>pain</strong>?<br />
Does medication work for non- There are not enough studies on any medicinal First 3-4 to 12 weeks: Offer limited courses of analgesia to relieve symptoms. Unknown<br />
C Some forms of medication can work taking in to<br />
<strong>specific</strong> <strong>neck</strong> <strong>pain</strong>?<br />
<strong>treatment</strong> to allow strong recommendation. Choice of analgesia depends on the severity, personal preferences,<br />
effectiveness is<br />
account it concerns acute, subacute or chronic<br />
Therefore all the following recommendations tolerability, <strong>and</strong> risk of adverse effects. Options include: paracetamol or found for drug<br />
non-<strong>specific</strong> <strong>neck</strong> <strong>pain</strong>:<br />
should be completed with key messages on ibuprofen taken as required, paracetamol regularly, ibuprofen taken regularly, <strong>treatment</strong>s for non-<br />
<strong>pain</strong> therapy as found in general guidelines paracetamol <strong>and</strong> ibuprofen taken regularly. Codeine taken inaddition to regular <strong>specific</strong> <strong>neck</strong> <strong>pain</strong><br />
o Local anaesthetics are effective in reducing<br />
(American Geriatrics Society<br />
paracetamol or ibuprofen if the response to either drug is insufficient. Codeine versus each other.<br />
chronic NNP.<br />
(http://www.americangeriatrics.org/), Sociéte should be prescribed separately to allow flexibility of dosing <strong>and</strong> titration of<br />
o An epidural injection of a corticoid plus local<br />
Scientifique de Médecine Générale<br />
analgesic effect. Combination products, such as co-codamol, are not Note: "We found no<br />
anaesthetic reduces <strong>pain</strong> for patients with chronic<br />
(http://www.ssmg.be)).<br />
recommended.<br />
direct information<br />
NNP.<br />
about wether<br />
o Botulinum toxin A is no better than saline<br />
analgetics<br />
injections for chronic NNP.<br />
(paracetamol,<br />
o Subcutaneous carbon dioxide insufflations are<br />
opiods), NSAIDs,<br />
no better than sham ultrasound (placebo<br />
antidepressants,<br />
<strong>treatment</strong>) for acute NNP.<br />
epidural<br />
o Paracetamol, (opoid) analgetics or NSAIDs on<br />
corticosteroids, or<br />
<strong>pain</strong> are beneficial, but no clear difference is found<br />
epidural local<br />
when analgetics <strong>and</strong>/or NSAIDs are compared<br />
anaesthetics are<br />
with each other.<br />
better than no<br />
o Chronic NNP patients with frequent acute<br />
active <strong>treatment</strong>."<br />
episodes of <strong>neck</strong> <strong>pain</strong> can be treated with<br />
oxycodone.<br />
10 Do education programs work for Educational programs focusing on First 3-4 weeks: reassure the person taht <strong>neck</strong> <strong>pain</strong> is a very common Unknown<br />
B Traditional <strong>neck</strong> schools are not beneficial<br />
patients with non-<strong>specific</strong> <strong>neck</strong> activation or on stress coping skills are not problem <strong>and</strong> that symptoms are likely to resolve. Encourage the person to effectiveness is<br />
remain active <strong>and</strong> return to a normal lifestyle. Strongly discourage prolonged found for patient<br />
<strong>pain</strong>?<br />
beneficial for NNP.<br />
abscence from work. Advise the person noit to drive if the range of motion of education <strong>treatment</strong><br />
for the <strong>treatment</strong> of NNP.<br />
the <strong>neck</strong> is restricted.<br />
for non-<strong>specific</strong> <strong>neck</strong><br />
From 3-4 weeks to 12 weeks:<br />
look for <strong>and</strong> address any psychosocial factors. Promote possitive attitudes to<br />
activity <strong>and</strong> work.<br />
<strong>pain</strong>.<br />
11 Are pillows effective in the The combination of exercises <strong>and</strong> a <strong>neck</strong> During the first 3-4 weeks:<br />
Unknown<br />
C<br />
<strong>treatment</strong> of non-<strong>specific</strong> <strong>neck</strong><br />
<strong>pain</strong>?<br />
pillow is effective to reduce <strong>pain</strong> for<br />
patients with chronic NNP.<br />
A firm pillow may provide comfort at night.<br />
effectiveness is<br />
found for pillows for<br />
non-<strong>specific</strong> <strong>neck</strong><br />
<strong>pain</strong>.<br />
12 Is the use of collars, oral splints There is no benefit for the use of soft Discourage the person from wearing a cervical collar; Neck supports, if used, Unknown<br />
B<br />
effective for patients with non<strong>specific</strong><br />
<strong>neck</strong> <strong>pain</strong>?<br />
collars or oral splints for patients with<br />
NNP.<br />
should be worn for as short a time as possible (2-4 days) <strong>and</strong> under<br />
effectiveness is<br />
supervision (e.g. by a physiotherapist), to ensure that mobilization is started found for soft collars<br />
as soon as possible.<br />
for non-<strong>specific</strong> <strong>neck</strong><br />
<strong>pain</strong>.<br />
13 Does acupuncture have a Acupuncture <strong>and</strong> more <strong>specific</strong>ally trigger From 3-4 to 12 weeks:<br />
Acupuncure is likely B<br />
positive effect on <strong>treatment</strong> of<br />
non-<strong>specific</strong> <strong>neck</strong> <strong>pain</strong>?<br />
point acupuncture can improve <strong>pain</strong> relief consider referral for acupuncture.<br />
for non-<strong>specific</strong> chronic <strong>neck</strong> <strong>pain</strong> <strong>and</strong> is<br />
relatively cost-effective.<br />
to be beneficial for<br />
the <strong>treatment</strong> of non<strong>specific</strong><br />
<strong>neck</strong> <strong>pain</strong>.<br />
B<br />
C<br />
B<br />
C<br />
C<br />
C<br />
C Education or counselling<br />
programmes for (female)<br />
computer workers is<br />
effective to decreasing<br />
<strong>pain</strong> intensity <strong>and</strong><br />
disability decrease.<br />
B