Summary of Recommendations for neck intervention:
NECK PAIN WITH MOBILITY DEFICITS Acute: - Clinicians should provide thoracic manipulation, a program of neck ROM exercises, and scapulothoracic and upper extremity strengthening to enhance program adherence. - Clinicians may provide cervical manipulation and/or mobilization. Sub acute: - Clinicians should provide neck and shoulder girdle endurance exercises. - Clinicians may provide thoracic manipulation and cervical manipulation and/or mobilization. Chronic: - Clinicians should provide a multimodal approach of the following: • Thoracic manipulation and cervical manipulation or mobilization • Mixed exercise for cervical/scapulothoracic regions: neuromuscular exercise (eg, coordination, proprioception, and postural training), stretching, strengthening, endurance training, aerobic conditioning, and cognitive affective elements • Dry needling, laser, or intermittent mechanical/manual traction - Clinicians may provide neck, shoulder girdle, and trunk endurance exercise approaches and patient education and counseling strategies that promote an active lifestyle and address cognitive and affective factors.
Read details of the guidelines: https://www. jospt.org/doi/full/10.2519/jospt.2017.0302
