Cervical spine findings on MRI in people with neck pain compared with pain‐free controls: A systematic review and meta‐analysis

Abstract Objectives Acute as well as chronic pain syndromes are common after whiplash trauma and exercise therapy is proposed as one possible intervention strategy. The aim of the present systematic review was to evaluate the effect of exercise therapy in patients with Whiplash-Associated Disorders for the improvement of neck pain and neck disability, compared with other therapeutic interventions, placebo interventions, no treatment, or waiting list. Content The review was registered in Prospero (CRD42017060356) and conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search in PubMed, Scopus and Cochrane from inception until January 13, 2020 was combined with a hand search to identify eligible randomized controlled studies. Abstract screening, full text assessment and risk of bias assessment (Cochrane RoB 2.0) were conducted by two independent reviewers. Summary The search identified 4,103 articles. After removal of duplicates, screening of 2,921 abstracts and full text assessment of 100 articles, 27 articles that reported data for 2,127 patients were included. The included articles evaluated the effect of exercise therapy on neck pain, neck disability or other outcome measures and indicated some positive effects from exercise, but many studies lacked control groups not receiving active treatment. Studies on exercise that could be included in the random-effect meta-analysis showed significant short-term effects on neck pain and medium-term effects on neck disability. Outlook Despite a large number of articles published in the area of exercise therapy and Whiplash-Associated Disorders, the current evidence base is weak. The results from the present review with meta-analysis suggests that exercise therapy may provide additional effect for improvement of neck pain and disability in patients with Whiplash-Associated Disorders.

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https://painphysicianjournal.com/current

January 2018 - Pain Physician ◽

10.36076/ppj.2020/23/335 ◽

2020 ◽

Vol 4;23 (7;4) ◽

pp. 335-348

Author(s):

Nicholas Van Halm-Lutterodt

Keyword(s):

Systematic Review ◽

Pain Relief ◽

Neck Pain ◽

Functional Status ◽

Spinal Stenosis ◽

Local Anesthetic ◽

Meta Analysis ◽

Chronic Neck Pain ◽

Epidural Injections ◽

Significant Difference

Background: Chronic neck pain is reportedly considered the fourth leading cause of disability. Cervical interlaminar epidural injections are among the commonly administered nonsurgical interventions for managing chronic neck pain, secondary to disc herniation and radiculitis, spinal stenosis, or chronic neck pain of discogenic origin. Objectives: To systematically review the differences in the effectiveness of cervical epidural injections with local anesthetics with or without steroids for the management of chronic neck pain. Study Design: Systematic review and meta-analysis. Methods: A comprehensive search of the literature of randomized controlled trials (RCTs) that compared epidural injections with local anesthetic with or without steroids was performed, including a search of PubMed, EMBASE, and Cochrane databases for all years up to May 2019. Meta-analysis was done for pain relief based on the Numeric Rating Scale, functional status based on the Neck Disability Index, and opioid intake dosage. Results: Four studies met the inclusion criteria. A total of 370 patients were divided into 2 groups: the experimental group received cervical epidural injection with steroid and local anesthetic, and the control group received injection with local anesthetic only. Regrading pain relief, no significant difference was observed between both groups (weighted mean difference [WMD], –0.006; 95% confidence interval (CI), –0.275 to 0.263; P = 0.963; I2 = 0.0% at 12 months). There was also no significant difference in the improvement of the functional status (WMD, 0.159; 95% CI, –1.231 to 1.549; P = 0.823; I2 = 9.8% at 12 months). Similarly, there was no significant difference in opioid dosage (WMD, –0.093; 95% CI, –5.952 to 5.766; P = 0.975; I2 = 0.0% at 12 months). Limitations: Only a few studies on this premise were found in the literature. There was also a lack of heterogeneity of the included RCT studies. Conclusions: The addition of steroids to anesthetic injectates was not associated with better pain and functional score outcomes compared with anesthetic injectate alone in patients with chronic neck pain. Key words: Chronic neck pain, cervical radiculopathy, cervical disc disease, spinal stenosis, facet joint pathology, cervical epidural injections, steroid injections, local anesthetic injections, systematic review, meta-analysis, randomized control trial

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Thoracic spine manipulation for the management of mechanical neck pain: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0211877 ◽

2019 ◽

Vol 14 (2) ◽

pp. e0211877 ◽

Cited By ~ 7

Author(s):

Michael Masaracchio ◽

Kaitlin Kirker ◽

Rebecca States ◽

William J. Hanney ◽

Xinliang Liu ◽

...

Keyword(s):

Systematic Review ◽

Neck Pain ◽

Thoracic Spine ◽

Meta Analysis

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Individuals With Chronic Neck Pain Have Lower Neck Strength Than Healthy Controls: A Systematic Review With Meta-Analysis

Journal of Manipulative and Physiological Therapeutics ◽

10.1016/j.jmpt.2018.12.008 ◽

2019 ◽

Vol 42 (8) ◽

pp. 608-622

Author(s):

Iã Ferreira Miranda ◽

Edgar Santiago Wagner Neto ◽

William Dhein ◽

Guilherme A. Brodt ◽

Jefferson F. Loss

Keyword(s):

Systematic Review ◽

Neck Pain ◽

Meta Analysis ◽

Chronic Neck Pain ◽

Healthy Controls ◽

Neck Strength ◽

Lower Neck

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The Impact of a Stabilization Exercise on Neck Pain: A Systematic Review and Meta-analysis

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0039-3400953 ◽

2020 ◽

Vol 81 (04) ◽

pp. 342-347

Author(s):

Binbin Wu ◽

Hongyan Yuan ◽

Deyu Geng ◽

Liang Zhang ◽

Cheng Zhang

Keyword(s):

Systematic Review ◽

Neck Pain ◽

Meta Analysis ◽

Neck Disability Index ◽

Depression Scale ◽

Cochrane Library ◽

Control Group ◽

Stabilization Exercise ◽

Pain Scores ◽

The Impact

Abstract Introduction The efficacy of a stabilization exercise for the relief of neck pain remains controversial. We conducted a systematic review and meta-analysis to explore the effectiveness of a stabilization exercise on neck pain. Methods We searched Embase, Web of Science, EBSCO Information Services, and the Cochrane Library databases through May 2019 for randomized controlled trials (RCTs) assessing the impact of a stabilization exercise on neck pain. This meta-analysis was performed using the random effects model. Results Six RCTs are included in the meta-analysis. Compared with the control group of patients with neck pain, a stabilization exercise can significantly reduce pain scores at 4 to 6 weeks (mean difference [MD]: −2.41; 95% confidence interval [CI], −4.46 to −0.35; p = 0.02), Neck Disability Index [NDI] at 10 to 12 weeks (MD:− 6.75; 95% CI, −11.71 to −1.79; p = 0.008), and depression scale at 4 to 6 weeks (MD: −4.65; 95% CI, −7.00 to −2.31; p = 0.02), but it has no obvious impact on pain scores at 10 to 12 weeks (MD: −1.07; 95% CI, −3.42 to 1.28; p = 0.37) or at 6 months (MD: −1.02; 95% CI, −3.43 to 1.39; p = 0.41). Conclusions A stabilization exercise can provide some benefits to control neck pain.

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