Doing some simple exercises at home is more effective than medicine at getting out a painful crick in the neck, a new study shows.
Neck pain afflicts at least three quarters of people at some point in their lives, and many take over-the-counter medications or visit doctors and chiropractors in search of relief. Sedentary office workers tend to be most susceptible to the condition. (click below to read more)
"It's good news for patients that there's something they can do themselves," says Gert Bronfort, vice president of research at Northwestern Health Sciences University in Bloomington, Minn., and the study's lead author. The study is the first large federally funded study comparing the treatments.
Dr. Bronfort and his research team designed it to compare spinal manipulation performed by a chiropractor, home exercises and medication for effectiveness at relieving neck pain. It was funded by the National Institutes of Health's center for complementary and alternative medicine and published Monday in the Annals of Internal Medicine. While spinal manipulation has been shown to be effective at treating lower back pain, less was known about the impact on the upper end of the spine.
Dr. Bronfort said a neck-retraction exercise, or chicken-like maneuver of the head, in which a people pull their heads back and then tilt their chins slightly downward "seemed to be especially useful."
The study also suggests people who have a chiropractor or physical therapist release tense joints and muscles through spinal manipulation can obtain relief from neck pain.
Study participants were recruited from people insured by Blue Cross/Blue Shield of Minnesota. The study involved 272 people who reported having neck pain without a specific cause for at least two weeks and no longer than three months. They were divided into three treatment groups. The study's goal was to test a theory that spinal manipulation would be more effective than home exercise or medication at relieving neck pain after 12 weeks of treatment.
What researchers actually found was spinal manipulation and home exercises were about equally effective at relieving neck pain. Both were better than medication alone at various time points during the study at reducing patient-rated neck pain. Pain and other measurements including how well people could move their necks were taken starting from two weeks to up to a year after the study started.
Dr. Bronfort explained people in the home exercise group were initially shown how to do the exercises but then left on their own to conduct the exercises. Patients in the spinal-manipulation group visited a chiropractor about twice a week during the study to have maneuvers performed on their upper spines.
Study participants were assigned to one of three groups. One group was assigned to treatment with chiropractors who set up individual treatment plans with patients including how often they were treated during the study.
Another group was assigned to home exercise sessions.
The people in that group underwent two, one-hour-long sessions that were designed to teach them the exercises, which involved gentle, controlled movements of the neck and shoulder joints. Participants were instructed to perform five to 10 repetitions of each exercise several times a day.
People in the medication group were treated with non-steroidal anti-inflammatory drugs like ibuprofen, acetaminophen and/or muscle relaxants. Some patients also received stronger narcotic medicines.
Advice on whether to stay active or modify activity was made on a case-by-case basis.
One measure showed about 80% of patients in the spinal-manipulation group and the home exercise groups reported a reduction of at least 50% in pain levels after 12 weeks compared with about 70% of people in the medication group.
About 30% of patients in the exercise and manipulation groups reported a 100% reduction in pain levels during the same time period compared with about 13% of patients in the medication group.
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