For neck pain: chiropractic and exercises
What is the best treatment for neck pain?
Seeing a chiropractor or doing light exercises relieves neck pain more effectively than relying on pain medications, new research shows.
The new study is one of the few comparisons hand in hand with several treatments for neck pain, a problem that affects three quarters of the American population at some time in their lives, but for which a treatment of front line While some people seek spinal manipulation by chiropractors, the evidence supporting its usefulness has been limited to the best.
But the new study, published in The Annals of Internal Medicine, found that chiropractic care or simple exercises performed at home were better for reducing pain than taking medications such as aspirin, ibuprofen or narcotics.
“These changes were decreasing over time, but they were still present,” said Dr. Gert Bronfort, a study author and research professor at the University of Northwest Health Sciences in Minnesota. “Even a year later, there were differences between spinal manipulation and drug groups.”
For neck pain: chiropractic and exercises
Moderate and acute neck pain is one of the most frequent reasons for visits to primary care doctors, causing millions of visits every year. For patients, this can be a difficult problem to handle. In some cases pain and stiffness arises without explanation, and treatment options are varied. Physiotherapy, pain medication and spinal manipulation are popular options, but Dr. Bronfort was inspired to carry out an analysis because there is very little research on it. “There was a gap in the scientific literature in terms of which treatments are the most useful,” he said.
To find out, Dr. Bronfort and his colleagues recruited a large group of adults with neck pain with no known specific cause. The subjects, 272 in total, were mostly recruited from a large HMO (Health Maintenance Organizations) and through advertisements. The researchers then separated them into three groups and followed up for approximately three months.
A group was assigned to visit a chiropractor in sessions of approximately 20 minutes throughout the course of the study, averaging 15 visits. A second group was assigned to take common pain relievers such as acetaminocene and, in some cases, at the doctor’s discretion, stronger medications such as narcotics and muscle relaxants. The third group met twice with physiotherapists who instructed them on simple and gentle neck exercises that they could do at home. They were encouraged to do 5 to 10 repetitions of each exercise up to eight times a day. (A demonstration of the exercises can be found at www.annals.org).
After 12 weeks, people in the group who were not medicated were significantly better than those taking drugs. About 57% of those who visited with chiropractors and 48% of those who exercised reported at least 75% reduction in pain, compared with 33% of people in the medication group.
A year later, when the researchers checked again, 53% of subjects who had received spinal manipulation still reported at least a 75% reduction in pain, similar to the exercise group. This compared to 38% of pain reduction among those who had been taking medication.
Dr. Bronfort said it was a “big surprise” to see that the exercises at home were as effective as chiropractic sessions. “We did not expect that the result would be so close,” he said. “But I guess this is good news for patients.”
In addition to their limited pain relief, medications have at least one other inconvenience: people continue to take them. “People in the medication group continued to use more medications more frequently throughout the follow-up period, up to a year later.” Dr. Bronfort said. “If you are taking medication for a long period of time, then we are generating more systemic side effects such as intestinal problems.”
Dr. also expressed concern that those who were medicating were not as empowered or active in their own care as those of the other groups. “We think it is important for patients to be able to deal with their own condition control as much as possible,” says Dr.
“This study shows that people can play a great role in their own care.”