Bart W. Koes
Most patients with acute neck pain (< 2 weeks) recover quickly and respond well to a wait-and-see approach. If the neck pain persists for more than 2 weeks there are various treatment options available. A new RCT from the USA has shown that spinal manipulation, or even a programme of home exercise, was more effective than medication (including analgesia) for patients with neck pain with a duration of 2-12 weeks. The magnitude of the difference in effectiveness of treatment was quite low. However, since the results are largely in line with a previous RCT from the Netherlands in which manual therapy showed the best clinical and cost-effective results compared to physiotherapy and usual care by the general practitioner, the evidence in favour of manual therapy is now accumulating. Manual therapy is a rational treatment option for patients with neck pain persisting longer than 2 weeks.
Conflict of interest: none declared. Financial support: none declared.
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