Seven-Year Neck Pain Study Sheds Light on Best Care

    TORONTO, Feb. 15 /CNW/ - A seven-year, international study published
today finds that some alternative therapies such as acupuncture, neck
manipulation and massage are better choices for managing most common neck pain
than many current practices. Also included in the short-list of best options
for relief are exercises, education, neck mobilization, low level laser
therapy and pain relievers.
    Therapies such as neck collars and ultrasound are not recommended. The
study found that corticosteroid injections and surgery should only be
considered if there is associated pain, weakness or numbness in the arm,
fracture or serious disease.
    The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its
Associated Disorders 236 page review of the current research on neck pain is
published in the journal Spine. The multi-national and inter-disciplinary
study team included Canadian, American, South American, Australasian and
European researchers. The Task Force was created to help neck pain sufferers
and health professionals use the best research evidence to prevent, diagnose
and manage neck pain.
    "Neck pain is not a trivial condition for many people," says Task Force
president Dr. Scott Haldeman, clinical professor, department of neurology at
the University of California, Irvine; and adjunct professor, department of
epidemiology University of California Los Angeles. "It can be associated with
headaches, arm and upper back pain and depression. Whether it arises from
sports injuries, car collisions, workplace issues or stress, it can be
incapacitating. Understanding the best way to diagnose and manage this problem
is of high importance for those who are suffering and for those who manage and
pay for its care."
    The study found that neck pain is a widespread experience that is a
persistent and recurrent condition for the majority of sufferers. It is
disabling for approximately two out of every 20 people who experience neck
pain and affects their ability to carry on with daily activities says the Task

    A key recommendation of the Task Force is that neck pain, including
whiplash-related pain, be classified and treated in a common system of 4

    Grade 1: neck pain with little or no interference with daily activities
    Grade 2: neck pain that limits daily activities
    Grade 3: neck pain accompanied by radiculopathy ("pinched nerve" - pain
             weakness and/or numbness in the arm)
    Grade 4: neck pain with serious pathology, such as tumor, fracture,
             infection, or systemic disease.

    "The majority of neck pain falls into Grades 1 or 2," says Task Force
member, Dr. Linda Carroll, Associate Professor, School of Public Health at the
University of Alberta, and Associated Scientist, Alberta Centre for Injury
Control and Research (ACICR). "Many sufferers manage to carry on with their
daily activities. Others find their pain interferes with their ability to
carry out daily chores, participate in favorite activities or be effective at
work. For these people, the evidence shows there are a relatively small number
of therapies that provide some relief for a while, but there is no one best
option for everyone."
    In addition to its comprehensive review of the existing body of research
on neck pain, the Task Force also initiated a new study into the association
between chiropractic care of the neck and stroke. This innovative piece of
research found that patients who visit a chiropractor are no more likely to
experience a stroke than are patients who visit their family physician. The
study concludes that this type of stroke commonly begins with neck pain and/or
headache which causes the patient to seek care from their chiropractor or
family physician before the stroke fully develops.
    "This type of stroke is extremely rare and has been known to occur
spontaneously or after ordinary neck movements such as looking up at the sky
or shoulder-checking when backing up a car," noted the study's lead author,
Dr. David Cassidy, professor of epidemiology at the University of Toronto and
senior scientist at the University Health Network at Toronto Western Hospital.
    For the minority of neck pain sufferers who experience Grade 3 neck pain -
that is neck pain accompanied by pain, weakness and/or numbness in the arm,
also referred to as a "pinched nerve", corticosteroid injections may provide
temporary relief says the study. Surgery is a last resort according to the
findings and should only be considered if accompanying arm pain is persistent
or if the person is experiencing Grade 4 pain due to serious injury or
systemic disease.

    Top findings for neck pain suffers:

    -   Stay as active as you can, exercise and reduce mental stress.
    -   Don't expect to find a single "cause" for your neck pain.
    -   Be cautious of treatments that make "big" claims for relief of neck
    -   Trying a variety of therapies or combinations of therapies may be
        needed to find relief - see the therapies for which the Task Force
        found evidence of benefits.
    -   Once you have experienced neck pain, it may come back or remain
    -   Lengthy treatment is not associated with greater improvements; you
        should see improvement after 2-4 weeks, if the treatment is the right
        one for you.
    -   There is relatively little research on what does or does not prevent
        neck pain; ergonomics, cervical pillows, postural improvements etc.
        may or may not help.

    "This is an important body of research that will help to improve the
quality of patient care by incorporating the best evidence into practice and
patient education," says Dr. Carroll. "Neck pain can be a stubborn problem -
we hope this comprehensive analysis of the evidence will help both sufferers
and health care providers better manage this widespread complaint."

    About the Bone and Joint Decade 2000-2010 Task Force On Neck Pain and Its
    Associated Disorders

    The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its
Associated Disorders is composed of a group of international researchers and
scientist-clinicians who have spent the past seven years undertaking a
comprehensive and structured review of the current research on neck pain. The
Scientific Secretariat of the Task Force is composed of 13 members and has
been supported by an international Advisory Committee of 17 members. The Task
Force and Advisory Committee members represent 14 disciplines ranging from
neurology and rheumatology to epidemiology, chiropractic and physical therapy
from across nine countries.

For further information:

For further information: Leslie Walsh, Fleishman-Hillard Canada, (416)

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