Evidence based practice for the stiff neck. Research has provided us with many different assessments, treatments, and therapeutic exercises for patients who have neck pain and do not have sufficient ROM. Watch the video below to learn about specific strategies to improve neck pain in patients with mobility deficits.
With many different options out there, in the end, the message is simple, you just have to move it :)
Snodgrass SJ et al. The clinical utility of cervical range of motion in diagnosis, prognosis, and evaluating the effects of manipulation: a systematic review. Physiotherapy. 2014;100:290-304.
A systematic review (36 papers). Restricted ROM has shown to be associated with negative outcomes, while greater ROM is shown to be associated with positive outcomes. Although there is still conflicting evidence for a prognostic values of cervical ROM.
Gross A, et al. Manipulation and mobilization for neck pain contrasted against an inactive control or another active treatment. Cochrane Database Syst Rev, 2015:CD004249.
A systematic review (5 RCT’s) suggested T/s manipulations improved neck pain and function.
Karas S, et al. The effect of direction specific thoracic spine manipulation on the cervical spine: a randomized controlled trial. Journal of Manual and Manip Therapy. Nov, 2016. (1-8)
A RCT that compared thoracic prone manipulation for extension vs. supine manipulation for flexion found that both groups had positive results when pain, neck disability index, and global rating of change were assessed.
Leaver AM, et al. Conservative interventions provide short-term relief for non-specific neck pain: a systematic review. J Physiotherapy. 2010;56:73-85.
No difference in regards to improving pain, function and disability when performing either cervical manipulations or cervical mobilizations (PA’s).
Young JL, et al. Thoracic manipulation versus mobilization in patients with mechanical neck pain: a systematic review. J Man Manip Ther. 2014;22:141-153.
A systematic review (14 studies) found that thoracic manipulations or mobilization improved cervical pain, range of motion, and disability.
Southerst D, et al. Is exercise effective for the management of neck pain and associated disorders or whiplash-associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Spine J. 2016;16:1503-1523.
Systematic review showing that patients may either do AROM with self OP, self mobilizations using hands or towel snags to maintain and gain C/s ROM through therapeutic exercise.