Not known if combining treatments leads to greater overall effects
Neck pain is a very common disorder that occurs in about 37% of the population. Some of these patients eventually go on to develop chronic neck pain, which means it’s long lasting without improving. Research has shown that specific training of muscles in the neck can reduce pain and disability in patients with chronic neck pain. Other studies have found that education is another effective way to help these patients by enhancing their understanding of chronic pain and teaching them the best ways to deal with it. Even though both of these methods have been found to be effective for chronic neck pain, it is not known if combining exercise training with education is superior to education alone. For this reason, a powerful study called a randomized-controlled trial (RCT) was conducted to compare the effects of both treatments for chronic neck patients.
Both treatments last for eight weeks
Individuals who had neck pain for at least six months were recruited and screened to determine if they could be included. A total of 15 people fit the necessary criteria and were included in the RCT. They were then randomly assigned to either the training and education (combination) group or the education-only group. The education-only group was used as the control and was compared with the effects found in the combination group. Both groups received four 1.5-hour long sessions of pain education over eight weeks, which covered topics like accepting pain, coping strategies for pain, and setting goals based on managing pain. The other group received eight 30-minute supervised training sessions in addition to the education. These sessions included balance exercises for the neck and shoulder as well as aerobic training, and patients were told to perform the balance exercises twice a day and aerobic training every other day. All patients were evaluated before the treatments, and then again four and 12 months later for a number of outcomes, including pain, balance and flexibility.
Combining both treatments leads to greater improvements for patients
Results showed that adding exercise training to education sessions led to superior effects when compared to education alone. This was mainly due to greater reductions in neck pain, but was also based on greater reductions of muscle activity in the neck—which is associated with less pain—and improved measures of balance. Unfortunately, the sample size in this study is considered small, and more research will be needed to confirm the results found here. Nonetheless, it appears that combining a specific exercise-training program with education sessions may be a better approach than education alone for patients who have chronic neck pain. Combining both of these elements in a treatment program may therefore lead to better overall results.
-As reported in the October’15 issue of Manual Therapy