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Physical medicine modalities for mechanical neck disorders
- Gross AR, Aker PD, Goldsmith CH, Peloso P
Cochrane Database Syst Rev 2000;(2):CD000961
School of Rehabilitation Science, McMaster University, 1200 Main Street
West, Hamilton, Ontario, Canada, L8N 3Z5. [email protected]
OBJECTIVES: Multiple physical medicine modalities are commonly included as
part of therapeutic interventions for mechanical neck disorders (neck pain).
The objective of this review was to assess the effects of physical medicine
modalities for pain in adults with mechanical neck disorders. SEARCH
STRATEGY: We searched Medline, Embase, Chirolars, Index to Chiropractic
Literature, Cinahl, Science Citation Index, Conference Proceedings Index,
National Technical Information Services and reference lists of the retrieved
articles from 1985 to December 1993 and we contacted content experts.
SELECTION CRITERIA: Randomised trials and controlled trials of physical
medicine modalities in adults with mechanical neck disorder. DATA COLLECTION
AND ANALYSIS: Three reviewers independently assessed trial quality and two
reviewers independently extracted data. Investigators were contacted to
obtain information or data that could not be found in the published reports.
MAIN RESULTS: Thirteen trials were included. The overall quality of the
included trials was generally good. Two trials using electromagnetic therapy
produced a significant reduction in pain (p <0.01) with three to four
weeks of daily (eight hours per day) therapy sessions; and three using laser
therapy did not differ significantly from a placebo (p=0.20) for six to 10
sessions of treatment. Not enough scientific testing exists to clearly
determine the effectiveness of other therapies. This includes treatments
such as exercise, traction, acupuncture, heat / cold applications,
electrotherapies, cervical orthoses and chronic pain / cognitive behavioral
rehabilitation strategies. REVIEWER'S CONCLUSIONS: There is little
information available from trials to support the use of physical medicine
modalities for mechanical neck pain. There is some support for the use of
electromagnetic therapy and against the use of laser therapy with respect to
pain reduction.
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