Neck Pain

Quebec Task Force Report

In 1995 the Quebec task force found that there was very little evidence to support any particular treatment methods for the care of whiplash associated disorders.

“Based on limited evidence and reasoning by analogy, it is the Task Force consensus that the use of nonsteroidal anti-inflammatory agents and analgesics, short term manipulation and mobilization by trained persons, and active exercises are useful in Grade II and III WAD, but prolonged use of soft collars, rest or inactivity probably prolongs disability in WAD”

Spitzer WO, Skovron ML et al (1995) Scientific Monograpgh of the Quebec Task Force on Whiplash –Associated Disorders: Refining Whiplash and its Management, Spine 20:8s.

The RAND Report

The next year research was published comfirming the findings of the Quebec Task Force. They found that cervical manipulation and mobilization were effective, safe and “appropriate” for many categories of patients with head and neck pain.

Coulter ID, Hurwitz EL, et al. (1996) The Appropriateness of Manipulation and Mobilisation of the Cervical Spine, RAND Santa Monica, California, Document No. MR-781-CR

In 1996 two studies on neck pain found that today there is better evidence for the effectiveness of manipulation than any other treatment for chronic neck pain.

Hurwitz EL, Aker PD etal. Manipulation and Mobilisation of the Cervical Spine, Spine, 1996; 21(15):1746-1760.

Aker PD, Gross A et al. Conservative Management of Mechanical Neck Pain: Systematic Overview and Meta-Analysis. Br Med J 1996;313:1291-1296.

Comparing Accupuncture, NSAID's and Spinal Manipulation

In an Australian Study comparing acupuncture, a NSAID, and spinal manipulation for chronic pain patients, patients receiving chiropractic care received an approximately 30% improvement. There was no change in patients using acupuncture or NSAID’s. No patients were made worse with chiropractic or acupuncture but three of the medicated patients had significant gastric problems as side effects.

Giles LGF, Müller R, Chronic Spinal Pain Syndromes: A Clinical Pilot Trial, JMPT, 1999;22(6):376-381.