Abstract
Objectives: To conduct an overview on psychological interventions, orthoses, patient education, ergonomics, and 1⁰/2⁰ neck pain prevention for adults with acute-chronic neck pain.Search Strategy: Computerized databases and grey literature were searched (2006-2012).Selection Criteria: Systematic reviews of randomized controlled trials (RCTs) on pain, function/disability, global perceived effect, quality-of-life and patient satisfaction were retrieved.Data Collection & Analysis: Two independent authors selected articles, assessed risk of bias using AMSTAR tool and extracted data. The GRADE tool was used to evaluate the body of evidence and an external panel to provide critical review.Main Results: We retrieved 30 reviews (5-9 AMSTAR score) reporting on 75 RCTs with the following moderate GRADE evidence. For acute whiplash associated disorder (WAD), an education video in emergency rooms (1RCT, 405participants] favoured pain reduction at long-term follow-up thus helping 1 in 23 people [Standard Mean Difference: -0.44(95%CI: -0.66 to -0.23)). Use of a soft collar (2RCTs, 1278participants) was not beneficial in the long-term. For chronic neck pain, a mind-body intervention (2RCTs, 1 meta-analysis, 191participants) improved short-term pain/function in 1 of 4 or 6 participants. In workers, 2-minutes of daily scapula-thoracic endurance training (1RCT, 127participants) over 10 weeks was beneficial in 1 of 4 participants. A number of psychosocial interventions, workplace interventions, collar use and self-management educational strategies were not beneficial.Reviewers' Conclusions: Moderate evidence exists for quantifying beneficial and non-beneficial effects of a limited number of interventions for acute WAD and chronic neck pain. Larger trials with more rigorous controls need to target promising interventions
Highlights
Description of the Condition neck pain can be recurrent, severe, disabling and is a socioeconomic burden on society [1, 2], it is most commonly simple and transient
We included 30 reviews on treatment (see Fig. 1 Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA)) [24] flow diagram representing 75 randomized controlled trials (RCTs) - 14 RCTs related to psychological interventions, 29 to ergonomic workplace interventions, 22 to orthotics, 22 to patient education, 6 to 10 prevention and 9 to 20 prevention; keep in mind that there was some overlap
The primary studies included in our analyses investigated the following 1)psychological categories: psychological, psychosocial interventions and mind-body; 2) workplace interventions and prevention: physical environment change, individual worker change, ergonomic and mental health education; organizational change; 3) patient education categories: advice on activation, advice on rest, pain and stress coping skills education, workplace ergonomic education +pain and stress coping skills education self-management educational strategies; and 4) orthotics categories: specialized pillow, specialized pillow + therapy, rigid collar, soft collar, soft collar + home exercise + physiotherapy, collar + advice for self-mobilization, kinesio taping, oral splint
Summary
Description of the Condition neck pain can be recurrent, severe, disabling and is a socioeconomic burden on society [1, 2], it is most commonly simple and transient. Helping people/patients change behavior may be an important factor when addressing lifestyle modifications needed for neck pain prevention and management [8]. This overview (review of review) addresses a diverse group of seemingly eclectic interventions that include interventions that may help people understand, independently self-manage, potentially limit the impact of injury on their neck pain/disability or prevent potential injury. Some interventions are intended to manage psychological distress related to neck pain and others such as patient education strategies, use of orthosis (i.e. collar), ergonomic workplace interventions, and preventions strategies, affect change in some aspect of the individual or their environment to aide in the management of neck pain
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