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Guidelines highlight importance of exercises for chronic neck pain


Many treatments are available for this extremely common condition


Chronic neck pain is defined as pain in the upper region of the spine that persists for more than three months. All forms of neck pain are common, but it is estimated that 14.3% of the U.S. population currently has chronic neck pain. Numerous treatments are available for chronic neck pain, including physical therapy and active exercise. When it comes to prescribing exercise, however, guidelines on its specific components-such as frequency, time, type and intensity-are lacking. For this reason, a powerful type of study called a meta-analysis was performed on all available literature to help better establish guidelines on exercise as treatment.



Only high-quality studies are included in review


To create these guidelines, numerous medical databases were searched for relevant studies. Results of this search were screened using inclusion criteria, which only allowed randomized controlled trials (RCTs) and other studies of a similar level of quality to be used. RCTs are considered one of the most powerful types of studies due to their design and structure. This search turned up 16 studies to be evaluated.



Exercise programs should last for a certain duration and include variation


The review found a wide range of evidence for different components of exercise programs, but researchers were able to extract the most consistent findings. The most beneficial frequency of exercise to target pain, weakness and quality of life was found to be three times per week. Intensity, which is measured based on an individual's maximal voluntary contraction, should be determined based on a patient's personal abilities and reach up to 80% at its highest. Variation was the most important factor for exercise type, as a combination of strengthening, stretching and aerobic exercise was found to be most effective for improving strength and reducing pain and disability. Finally, it was determined that exercise sessions should ideally last for 30-45 minutes each, and the whole program should continue for at least six weeks, but up to 12 weeks for optimal results. By working with a physical therapist and closely following these guidelines, patients with chronic neck pain can expect to experience significant improvements that will continue in the long-term if they follow through and make exercise a regular part of their lives.



-As reported in the April '14 edition of the Archives of Physical Medicine and Rehabilitation
January 29, 2015
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