The Net Guide: Neck Pain

Pain Management, September 2010, Volume 3, Issue 6

A collection of links and resources from across the web focused on one specific condition. These resource range from useful websites to clinical trials.

//The Educated Patient Neck Pain — Up-to-Date

Here, your patients can learn about neck anatomy; the causes of neck pain and conditions, including cervical strain and whiplash injury; the tests used to determine the severity of the pain; treatments offered; and more. Written by physicians and based on the latest research, the material presented guides the patient in an easy-to-follow manner and answers most of the typical questions a neck pain patient may have. The “Treatment”

section provides an overview of therapeutic options based on the severity of the patient’s pain, discussing remedies such as ice, stretching exercises, over-the-counter pain relievers, and alternative choices such as acupuncture and biofeedback.

All About Back and Neck Pain

This site provides an in-depth look at some of the most common causes of neck pain and uses visualizations and simple descriptive language to help readers understand the information and concepts. For example, the site’s description of degenerative disc disease asks readers to “compare a spinal segment to two vanilla wafers (the ‘vertebrae’) and a marshmallow (the ‘disc’)” and imagine the effects on the marshmallow when the “wafers” press together. Readers are told that a normal, healthy disc is like a fresh marshmallow, whereas a disc affected by degenerative disc disease is more akin to a stale, dried-out marshmallow that “is not quite as spongy” and has lost its “shock absorbing ability.” Readers will also find a review of neck and spine anatomy; tools to help locate a back and neck pain specialist; and a “Learn from Experts & Patients” section, which features frequently asked questions and personal stories from patients.

Neck Pain at Your Orthopaedic connection

Provided by the American Academy of Orthopaedic Surgeons, this site provides information about the causes of neck pain and advice for patients on the symptoms that should prompt them to seek medical care for neck pain.

Link Code: pm3623

Chronic Neck Pain:

What Condition Is Causing My Neck Pain?

The article featured on this page from Spine-Health presents a list of symptoms

and characteristics of several common causes of chronic neck pain to help patients with neck pain conditions determine which condition they may be suffering from. For example, the site features categories such as “Neck pain that is related to certain activities or positions,” and goes on to explain the causes of neck pains associated with certain movements.

Necksurgery.com

Patients can track their neck pain by using the seven day journals, send e-cards to friends announcing their surgery plans or thank you notes, check out the “Ask My Doctor” question list to present at their next visit, and much more at this website. Necksurgery.com is a comprehensive site featuring articles, patient stories, information on wellness and neck pain management, and informative video clips for the patient with neck pain.

//eABSTRACTS

Cervical Epidural Injections in Chronic Discogenic Neck Pain without Disc Herniation or Radiculitis: Preliminary Results of a Randomized, Double-blind, Controlled Trial

Journal: Pain Physician (July 2010)

Authors: Manchikanti L, Cash K, Pampati V, et al

Purpose: The study was designed to “evaluate the effectiveness of cervical interlaminar epidural injections with local anesthetic with or without steroids in the management of chronic neck pain.”

Results: Patients who had disc herniation or radiculitis and tested “negative for facet joint pain” were randomized into two groups: one that received “injection of local anesthetic only” or one that received “local anesthetic mixed with non-particulate

betamethasone.” The findings revealed that “significant pain relief was demonstrated in 80% of patients in both groups and functional status improvement in 69% of Group I and 80% of Group II.” They concluded that “cervical interlaminar epidural injections with local anesthetic with or without steroids may be effective in patients with chronic function-limiting discogenic.”

Multimodal Group Rehabilitation Compared to Usual Care for Patients with Chronic Neck Pain: A Pilot Study

Journal: Pain Practice (July 19, 2010)

Authors: Hudson J, Ryan C

Purpose: The researchers sought to “compare multimodal group rehabilitation to usual care physiotherapy for patients with chronic neck pain” through a randomized-controlled trial.

Results: The study included 14 participants who were randomly assigned to two interventions: multimodal group rehabilitation (MGR) or usual care physiotherapy (UCR). MGR “involved stability, strengthening and proprioceptive exercises along with an educational [program].” The patients attended MGR for one hour, “once a week for six weeks.” The UCR group “was treated as deemed appropriate by their physiotherapist.” The researchers concluded that the “results warrant further investigation of multimodal group rehabilitation for CNP, and provide data to inform an appropriately.

Prognosis of Patients with Nonspecific Neck Pain: Development and External Validation of a Prediction Rule for Persistence of Complaints

Journal: Spine (July 12, 2010)

Authors: Schellingerhout J, Heymans M, Verhagen A, et al

Purpose: The team sought to develop and validate “a prediction rule that estimates the probability of complaints persisting for at least six months in patients presenting with nonspecific neck pain in primary care.”

Results: Researchers studied a sample from the adult primary care population (18-70 years) in The Netherlands presenting with nonspecific neck pain. The team used “multivariable backward stepwise logistic regression analysis” to identify “significant predictors.” A score chart was also developed. The team’s analysis “resulted in a set of nine predictors.” The team was able to “develop a score chart, estimating the probability of persistent complaints at six months follow-up for patients with nonspecific neck pain.”

Manual Therapy and Exercise for Neck Pain: A Systematic Review

Journal: Manual Therapy (June 1, 2010)

Authors: Miller J, Gross A, D’Sylva J, et al

Purpose: The group systematic review update “assesses if manual therapy, including manipulation or mobilization, combined with exercise, improves pain, function/disability, quality of life, global perceived effect, and patient satisfaction for adults with neck pain with or without cervicogenic headache or radiculopathy.”

Results: The review analyzed data from computer searches up to July 2009. “Pooled relative risk (pRR) and standardized mean differences (pSMD) were calculated. Of 17 randomized controlled trials included, 29% had a low risk of bias.” The team evaluated studies featuring low quality evidence, high quality evidence, and moderate quality evidence. “Specific research recommendations are made.”

//CLINICAL TRIALS

The Effectiveness of a Mechanical Manual Therapy Device in the Treatment of Neck Pain

Study Type: Interventional

Age/Gender Requirements: 18-60 years (male/female)

Sponsor: University of Florida

Purpose: The study is designed to compare “the effectiveness of a mechanical manual therapy device to a specific exercise” in the treatment of individuals experiencing neck pain.

Identify Patients with Neck Pain Likely to Benefit from Education and Exercise

Study Type: Interventional

Age/Gender Requirements: 18 years (male/female)

Sponsor: University of Central Florida

Purpose: The “project is to develop a clinical prediction rule (CPR) to identify which patients with neck pain have a greater probability of benefiting from a standardized program of education and exercise.”

Electroacupuncture and Laser Therapy on Neck Pain

Study Type: Interventional

Age/Gender Requirements: 18-70 years (male/female)

Sponsor: Logan College of Chiropractic

Purpose: The study will examine “the use of electroacupuncture and laser therapy to treat chronic neck pain.”

Link Code: pm3663